Intravenous iron supplementation after kidney transplantation

Background: We sought to evaluate the effect of intravenous (IV) iron supplementation on hemoglobin (Hb) levels and detect predictors for response. Methods: This is a retrospective cohort study of 81 patients who were treated with IV iron post-transplant. We evaluated predictors of response to treatment defined as an increase in Hb value of more than 1 g/dL by linear regression analysis. Results: Three months after treatment, the mean Hb level increased significantly from 9.8 ± 1.4 g/dL to 11.1 ± 1.6 g/dL (p < 0.001). A lower baseline Hb value (OR: 0.51, 95% CI: 0.33-0.78 per 1 g/dL increase) was the only predictor of response at three months. The Hb value in the evaluable 60 patients at one yr increased from 9.9 ± 1.4 g/dL to 11.7 ± 1.7 g/dL (p < 0.001). Lower baseline Hb value (OR: 0.34, 95% CI: 0.18-0.65 per 1 g/dL increase) and a shorter time from transplantation (OR: 0.8, 95% CI: 0.68-0.94 per one yr increase) were predictors of response. Adverse events were reported in five patients (0.7% of doses). The rate of estimated glomerular filtration rate decline was reduced following the IV iron treatment -0.34 ± 1.05 mL/min/month after treatment compared with -0.81 ± 1.11 mL/min/month before treatment (p = 0.013). Conclusions: IV iron treatment was safe and associated with Hb increase in a cohort of patients after kidney transplantation.