Does iron cause bacterial infections in patients with end stage renal disease?

ANNA J. 1999 Dec;26(6):591-6.


Anemia management using erythropoietin and intravenous iron supplementation has improved the lives of many patients with end stage renal disease (ESRD). However, because iron is an essential nutrient for microorganisms, it is plausible that iron supplementation may promote infection. This review examines the literature on the connection between iron and infection, with a focus on the relevance of these data to hemodialysis patients treated according to the National Kidney Foundation--Dialysis Outcomes Quality Initiative (NKF-DOQI) Guidelines for Anemia Management. The current evidence does not show a cause-and-effect relationship between intravenous iron administration and an increased susceptibility to infection in hemodialysis patients. Therefore, the author does not recommend changing current iron management practices in ESRD patients because of concern about infectious risk.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / etiology*
  • Bacterial Infections / chemically induced*
  • Erythropoietin / therapeutic use
  • Evidence-Based Medicine
  • Humans
  • Iron Compounds / adverse effects*
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / immunology
  • Kidney Failure, Chronic / therapy
  • Practice Guidelines as Topic
  • Renal Dialysis
  • Research Design
  • Risk Factors


  • Iron Compounds
  • Erythropoietin