PIVOTAL

Proactive IV Iron Therapy in Haemodialysis Patients

Paziente / Popolazione Intervento / Esposizione Confronto Esito

In 2,141 incident haemodialysis patients, proactive high-dose intravenous iron reduced death and cardiovascular events compared with a reactive low-dose regimen.

2141

Disegno

Open-label RCT

Esito

Composite of death, MI, stroke or HF hospitalisation

Rilevanza

Risultato29.3% vs 32.3%; HR 0.85 (95% CI 0.73–1.00; p=0.04), also lowering the ESA dose.

Macdougall IC, et al. N Engl J Med. 2019;380(5):447-458. 10.1056/NEJMoa1810742

Discussione e critica

Higher iron dosing proved safe and effective without an excess infection signal.