Recent advances in the use of intravenous iron in cardiorenal disease: a review of efficacy and safety.

Abstract

Purpose of review: Cardiorenal disease is commonly complicated by iron deficiency, which worsens clinical outcomes regardless of haemoglobin levels. This review evaluates recent evidence on intravenous iron therapy in this setting.

Recent findings: Recent randomized trials demonstrate the important role of intravenous iron in improving functional status and quality of life as well as reducing hospitalizations in patients with heart failure and iron deficiency. In chronic kidney disease, intravenous iron showed potential cardiovascular benefits beyond anaemia correction and is now recommended in updated guidelines. Although historically there were concerns regarding adverse reactions, recent trial data using modern high-dose intravenous irons have demonstrated an acceptable safety profile.

Summary: Intravenous iron offers clinical benefits in cardiorenal disease, supporting its expanded use even in the absence of anaemia. Broader adoption in clinical practice remains limited despite updated guidelines. Whilst safety data are generally reassuring, further studies will help define long-term safety and optimal use in non-dialysis, non-anaemic populations.