🔍 Clinical interpretation:
• Patients receiving IV iron (n=103) have average ferritin = 522 ng/mL
• Patients receiving oral iron (n=13) have average ferritin = 226 ng/mL
⚠️ Key message: IV iron drives ferritin more than double that of oral iron. However, high ferritin does NOT mean better anemia control. Many guidelines now recommend avoiding IV iron when ferritin >500 ng/mL unless TSAT is very low. Our data shows that routine IV iron pushes most patients into the 500+ range – which may be unnecessary and potentially harmful (oxidative stress, infection risk, vascular calcification).
✅ Suggestion: Consider switching stable patients with ferritin >500 ng/mL to oral iron or stopping iron altogether, monitoring Hb and TSAT closely.
Data source: Our hemodialysis center | IV iron group: n=103 | Oral iron group: n=13