Does Intravenous Iron Improve Survival and Physical Function and Reduce Heart Failure Events in Patients with Chronic Kidney Disease?

AbstractIron deficiency is common in patients with chronic kidney disease (CKD). Contemporary guidelines recommend the use of iron therapy only in the presence of anemia. However, patients with CKD are at increased risk of heart failure, and the coexistence of both conditions is associated with impaired quality of life, reduced physical function, and increased mortality compared with either condition alone. In this Tomorrow's Trial article, we review current evidence for intravenous iron in CKD and heart failure and propose the design of a randomized trial of intravenous iron, independent of hemoglobin, to assess its effects on mortality, heart failure, and physical function.