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PIVOTAL trial: iron loading improves clinical outcomes

The PIVOTAL trial shows that proactive intravenous (i.v.) iron administration reduces cardiovascular events and deaths, transfusions and erythropoiesis-stimulating agent doses and does not increase infections in patients on haemodialysis. These findings upend the warnings of guidelines and experts about the dangers of i.v. iron and prove that maintaining low iron stores is harmful.

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Correspondence to Daniel W. Coyne.

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Competing interests

D.W.C. is or has been a consultant to Vifor, Fibrogen, GlaxoSmithKline, Fresenius Medical Care Renal Therapies Group (FMC-RTG), Medibeacon and Reata. He is a speaker for FMC-RTG.

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Coyne, D.W. PIVOTAL trial: iron loading improves clinical outcomes. Nat Rev Nephrol 15, 260–261 (2019).

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