Data from the Dialysis Outcomes and Practice Patterns Study validate an association between high intravenous iron doses and mortality.

This is a very well done and important work. Bailie and co-authors stratified chronic kidney disease populations across different co-morbidities and showed that higher maintenance doses of intravenous iron are associated with poorer outcomes. The details are splendidly outlined in the manuscript.

This paper provides a compelling need for properly powered prospective studies to outline the optimal method of intravenous iron replacement in a population where it still clearly is an obligate need. The accompanying editorial by Weiss and Kronenberg poignantly points out how the economics of bundling affected changes in iron dosing. The message is sobering.

– Michael Auerbach

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