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dc.contributor.authorPIVOTAL investigators and committees
dc.contributor.authorFarrington, Kenneth
dc.date.accessioned2020-04-15T00:06:41Z
dc.date.available2020-04-15T00:06:41Z
dc.date.issued2020-05
dc.identifier.citationPIVOTAL investigators and committees & Farrington , K 2020 , ' Intravenous Iron Dosing and Infection Risk in Patients on Hemodialysis : A Prespecified Secondary Analysis of the PIVOTAL Trial ' , Journal of the American Society of Nephrology , vol. 31 , no. 5 , pp. 1118-1127 . https://doi.org/10.1681/ASN.2019090972
dc.identifier.issn1046-6673
dc.identifier.otherPURE: 20712599
dc.identifier.otherPURE UUID: 30e2b981-89ab-42eb-a52f-41c583f92cd9
dc.identifier.otherPubMed: 32253271
dc.identifier.otherScopus: 85083790255
dc.identifier.urihttp://hdl.handle.net/2299/22575
dc.descriptionFunding Information: Dr. Anker reports grants and personal fees from Vifor Int, personal fees from Bayer, personal fees from Boehringer Ingelheim, personal fees from Novartis, personal fees from Servier, grants and personal fees from Abbott Vascular, personal fees from Impulse Dynamics, and personal fees from SJM outside the submitted work. Dr. Bhandari reports personal fees from Phar-macosmos and personal fees from Vifor Pharma during the conduct of the study. Dr. Ford reports grants from Kidney Research UK during the conduct of the study. Dr. Kalra reports grants and personal fees from Vifor during the conduct of the study as well as grants and personal fees from Vifor, personal fees from Pharmacosmos, grants and personal fees from Astellas, personal fees from Bayer, personal fees from MundiPharma, personal fees from Napp, personal fees from AstraZeneca, grants from BergenBio, personal fees from Boehringer Ingelheim, and personal fees from Novonordisk outside the submitted work. Dr. Mark reports personal fees and nonfinancial support from Vifor, personal fees from Astrazeneca, grants from Boehringer Ingelheim, personal fees and nonfinancial support from Pharmacosmos, personal fees from Jans-sen, personal fees from Novartis, personal fees from Pfizer, personal fees from Bristol Myers Squibb, and personal fees and nonfinancial support from Napp outside the submitted work. Dr. Macdougall reports grants and personal fees from Vifor Pharma outside the submitted work. Dr. McMurray reports nonfinancial support and other from AstraZeneca during the conduct of the study as well as other from Bayer, nonfinancial support and other from Cardiorentis, nonfinancial support and other from Amgen, nonfinancial support and other from Oxford University/Bayer, nonfinancial support and other from Thera-cos, nonfinancial support and other from Abbvie, other from DalCor, other from Pfizer, other from Merck, nonfinancial support and other from Novartis, nonfinancial support and other from Glaxo Smith Kline, other from Bristol Myers Squibb, nonfinancial support and other from Vifor-Fresenius, nonfinancial support and other from Kidney Research UK, and nonfinancial support and other from Novartis outside the submitted work. Dr. Robertson reports grants from University of Glasgow during the conduct of the study. Dr. Wheeler reports grants and personal fees from Vifor Fresenius during the conduct of the study as well as personal fees from Amgen, personal fees from AstraZeneca, personal fees from Bayer, personal fees from Boehringer Inge-hiem, personal fees from GlaxoSmithKline, personal fees from Janssen, personal fees from Napp, personal fees from Mundipharma, and personal fees from Reata outside the submitted work. All remaining authors have nothing to disclose. Funding Information: The Proactive IV Iron Therapy in Haemodialysis Patients (PIVOTAL) trial was funded by Kidney Research UK, which was supported by an unrestricted grant from Vifor Fresenius Medical Care Renal Pharma Ltd. Publisher Copyright: Copyright © 2020 by the American Society of Nephrology.
dc.description.abstractBACKGROUND: Experimental and observational studies have raised concerns that giving intravenous (IV) iron to patients, such as individuals receiving maintenance hemodialysis, might increase the risk of infections. The Proactive IV Iron Therapy in Haemodialysis Patients (PIVOTAL) trial randomized 2141 patients undergoing maintenance hemodialysis for ESKD to a high-dose or a low-dose IV iron regimen, with a primary composite outcome of all-cause death, heart attack, stroke, or hospitalization for heart failure. Comparison of infection rates between the two groups was a prespecified secondary analysis. METHODS: Secondary end points included any infection, hospitalization for infection, and death from infection; we calculated cumulative event rates for these end points. We also interrogated the interaction between iron dose and vascular access (fistula versus catheter). RESULTS: We found no significant difference between the high-dose IV iron group compared with the lose-dose group in event rates for all infections (46.5% versus 45.5%, respectively, which represented incidences of 63.3 versus 69.4 per 100 patient years, respectively); rates of hospitalization for infection (29.6% versus 29.3%, respectively) also did not differ. We did find a significant association between risk of a first cardiovascular event and any infection in the previous 30 days. Compared with patients undergoing dialysis with an arteriovenous fistula, those doing so via a catheter had a higher incidence of having any infection, hospitalization for infection, or fatal infection, but IV iron dosing had no effect on these outcomes. CONCLUSIONS: The high-dose and low-dose IV iron groups exhibited identical infection rates. Risk of a first cardiovascular event strongly associated with a recent infection.en
dc.format.extent10
dc.language.isoeng
dc.relation.ispartofJournal of the American Society of Nephrology
dc.subjectNephrology
dc.titleIntravenous Iron Dosing and Infection Risk in Patients on Hemodialysis : A Prespecified Secondary Analysis of the PIVOTAL Trialen
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Clinical, Pharmaceutical and Biological Science
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85083790255&partnerID=8YFLogxK
rioxxterms.versionAM
rioxxterms.versionofrecordhttps://doi.org/10.1681/ASN.2019090972
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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