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Effects of Intravenously Administered Iron on Systemic Blood Pressure in Hemodialysis Patients

Background/Aims: Although maintenance of iron stores by intravenous iron infusion has become increasingly common in chronic hemodialysis patients, the effects of intravenous iron on blood pressure are not clear. Methods: In 52 mostly African-American patients in an urban setting, we reviewed blood pressure data over the course of hemodialysis on days that intravenous iron was administered and on control days. Results: The drop in blood pressure from the beginning to the end of hemodialysis was more pronounced when iron was not administered (9.9 ± 1.2 mm Hg) compared to when iron was administered (4.1 ± 1.7 mm Hg; p < 0.01). In a subset of chronic hemodialysis patients, blood pressure was actually higher at the end of hemodialysis compared to at the onset (9.6% of control hemodialysis sessions and 32.7% of sessions in which iron was administered; p < 0.01). The incidence of intra-dialytic hypotension and related symptoms was similar on iron and non-iron days. Conclusion: Intravenous iron therapy, well entrenched in clinical practice for the treatment of the anemia of end-stage renal disease, may reduce the incidence and magnitude of post-dialytic hypotension.