Tag Archives: intravenous iron

Introduction The European Society of Cardiology (ESC) heart failure guideline has undergone major updates every few years, with recent publications being in 2016 and 2021, respectively.1,2 Advances within heart failure care continue at pace, with presentation and publication of key randomised-controlled trials (RCTs) and meta-analyses being seen at the major cardiology scientific congresses. Given the likely impact of several trials on heart failure management and patient outcomes, the decision was made to publish a focused update in 2023 incorporating the most recent data.3 After robust review by the ESC guideline task force, only trials th

New generation diabetes drugs – a cardiorenal done deal? The meeting was opened by Professor William Herrington (Honorary Consultant Nephrologist, Oxford Kidney Unit) who discussed the impact of the new generation diabetes drugs on kidney outcomes.1 A meta-analysis of over 90,000 patients showed that sodium glucose co-transporter-2 (SGLT2) inhibitors slowed chronic kidney disease (CKD) progression by 37%, and decreased the risk of acute kidney injury, cardiovascular (CV) death or heart failure hospitalisation by 23%, regardless, the presence of diabetes or type of SGLT2 inhibitor used. Implementing these drugs is simple and can be done by

SAPIEN valve positive results Clinicians have achieved successful one-year outcomes in high-risk or inoperable patients undergoing transcatheter aortic valve replacement during the first two years since release of the valve (Sapien®, Edwards) commercially, according to results presented at the Euro PCR 2001 meeting in Paris, France. Despite high predicted mortality and multiple co-morbidities in many of these patients, survival at one year was 76% in the 1,038 patients treated as part of Cohort I (first year of commercialisation), and 77% in the 1,269 patients treated as part of Cohort II (second year of commercialisation).  Since November

The situation in the anaemia of CHF is less advanced, but in recent years there has been increasing interest in the use of both of these treatment strategies. A few small clinical trials have suggested some potential benefits of stimulating erythropoiesis with ESA therapy in heart failure anaemia, whilst the administration of IV iron has shown similar benefits even in the absence of ESA therapy. Indeed, the recently published FAIR-HF (Ferinject® Assessment in patients with Iron deficiency and chronic Heart Failure) trial1 has opened the eyes of cardiologists to the potential for this latter treatment strategy to improve the symptoms and sig

Epidemiology of anaemia in CKD The likelihood of anaemia occurring in CKD increases as renal function declines. All patients receiving haemodialysis therapy will require treatment for anaemia, and so too will almost all of those receiving peritoneal dialysis (the difference accounted for by haemodialysis exposing the patient to a greater inflammatory state, and also regular minor blood losses). Below a glomerular filtration rate (GFR) of 45 ml/min, erythropoietin secretion by the kidney declines and when patients enter stage 4 CKD (eGFR < 30 ml/min), around 30–40% will be anaemic. Aetiology of anaemia in CKD Figure 1. Factors contributi