IV iron therapy may not improve exercise ability in patients with CKD
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Key takeaways:
- Patients were given a single dose of 1,000mg of IV iron or placebo.
- Researchers found no mean between-group difference in the 6-minute walk test at 4 weeks.
Intravenous iron therapy did not improve exercise capacity in nonanemic patients with iron deficiency who have chronic kidney disease, according to recently published data.
“We examined whether a strategy of IV iron therapy in patients with stages 3 [to] 4 [chronic kidney disease] CKD who were iron-deficient but not anemic leads to improvements in exercise capacity, physical function and fatigue; and explored the effects of combined exercise training and iron therapy,” Sharlene A. Greenwood, a consultant physiotherapist at King’s College Hospital and lead researcher, wrote in the study.
Patients were given a single dose of 1,000 mg of IV iron or placebo. Image: Adobe Stock.
The Iron and Muscle Trial was a prospective, multicenter double-blind randomized controlled trial involving 75 patients. Patients not given the placebo received a single dose of 1,000mg of IV iron and were monitored for changes in exercise capacity.
Researchers’ primary objective was to evaluate the effect of IV iron therapy compared to a placebo, using the distance patients walked during the 6-minute walk test 4 weeks after iron infusion. They also studied 6-minute test results at 12 weeks, transferrin saturation, serum ferritin, hemoglobin, renal function, muscle strength, functional capacity, quality of life and adverse events at baseline and at 4 and 12 weeks, according to the research.
Results showed no significant mean between-group difference in the 6-minute walk distance at 4 weeks. There were also no notable differences in secondary outcomes, according to the results.
“Our results revealed no significant change in the primary endpoint ... when compared with baseline, between participants,” the researchers wrote. “There were also no significant between-group differences in measures of muscle strength, physical function, aerobic capacity, fatigue, work and social adjustment, or health-related quality of life.”
Researchers found substantial increases in serum ferritin and transferrin saturation at 4 and 12 weeks, as well as hemoglobin at 12 weeks, and no adverse events attributable to the iron therapy.
“The impact of iron therapy on these important patient-reported outcomes may be explored further in larger studies with longer participant follow-up,” they wrote. “Adequately powered studies ... are warranted to investigate functional improvement in nonanemic patients with iron deficiency and CKD who are treated with IV iron.”
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