Impact of intravenous ferric carboxymaltose on physical performance and patient-reported outcomes in elderly patients with non-dialysis CKD, mild anemia, and iron deficiency: A pilot study.

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Title:	Impact of intravenous ferric carboxymaltose on physical performance and patient-reported outcomes in elderly patients with non-dialysis CKD, mild anemia, and iron deficiency: A pilot study.
Alternate Title:	Impacto de la carboximaltosa ferrica intravenosa en los resultados comunicados por los pacientes en ancianos con ERC sin diálisis, anemia leve y deficiencia de hierro: estudio piloto.
Authors:	Puchades, Maria Jesús^1,2,3,4 majepu@uv.es, Casas, Juan⁵, Nuñez, Julio^2,3,6, Gimenez-Civera, Elena^1,3, Gonzales, Boris^1,3, Montomoli, Marco^1,3, Espriella, Rafael de la^2,3,6, Gonzalez-Rico, Miguel^1,3, Torregrosa, Isidro^1,2,3, Peñ, Carlos J.³, Cases, Aleix⁶, Gorriz, Jose Luis^1,2,3
Source:	Nefrologia. Feb2026, Vol. 46 Issue 2, p1-7. 7p.
Subjects:	PATIENT reported outcome measures, IRON deficiency, KIDNEY failure, ANEMIA, PHYSICAL mobility, OLDER patients, IRON supplements, PILOT projects
Abstract (English):	Background: Iron deficiency (ID) is highly prevalent in chronic kidney disease (CKD) and it's associated with poorer quality of life (QoL) and functional capacity. Intravenous iron therapy is limited to CKD patients with ID and anemia to avoid/delay the need or reduce the dose of erythropoiesis-stimulating agents, according to guidelines. We hypothesized that treatment with IV iron in CKD patients with ID and borderline anemia may improve their physical performance and QoL, independently of its effects on hemoglobin. Methods: Prospective, single-arm study in CKD patients with ID and mild anemia. The 6-min walk test (6-MWT), Piper fatigue scale, Patient's global assessment (PGA) and QOL (EQ-5D) questionnaires were evaluated at baseline, and at weeks 1 and 4 after receiving IV ferric carboxymaltose. Changes in continuous endpoints and their longitudinal trajectories were estimated with linear mixed regression models (LMRMs). Results: Forty-one patients completed the study. The 6-MWT increased from 296 ± 101 m to 314 ± 106 m at week 1 (p < 0.01), and to 325 ± 111 meters at week 4 (p < 0.01). PGA, EQ-5D questionnaire and Piper Fatigue scale significantly improved at week 4 from baseline (p < 0.05), after adjustment in the last 2 variables. Hemoglobin levels did not increase significantly during the follow-up. Conclusions: IV ferric carboxymaltose (IV FCM) was associated with a significant short-term improvement in the 6-MWT in CKD patients with iron deficiency and mild anemia. PGA, EQ-5D and Piper Fatigue Scale also improved at 4 weeks. These findings suggest a potential short-term benefit of IV ferric carboxymaltose on physical performance and PROMs in this population, independent of hemoglobin changes; however, given the small sample size and absence of a control group, results should be interpreted with caution and considered hypothesis-generating. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Antecedentes: El déficit de hierro (DH) es altamente prevalente en la enfermedad renal crónica (ERC), y se asocia con una peor calidad de vida y capacidad funcional. Según las guías clínicas, el tratamiento con hierro intravenoso está limitado a los pacientes con ERC que presentan DH y anemia, con el objetivo de evitar o retrasar la necesidad de agentes estimulantes de la eritropoyesis, o reducir su dosis. Nuestra hipótesis fue que el tratamiento con hierro intravenoso en los pacientes con ERC, DH y anemia leve podría mejorar su rendimiento fisico y calidad de vida, independientemente de su efecto sobre la hemoglobina. Metodos: Estudio prospectivo, de un solo brazo, en los pacientes con ERC, ID y anemia leve. Se evaluaron el test de marcha de 6 min (6-MWT), la escala de fatiga de Piper, la evaluación global del paciente (PGA) y los cuestionarios de calidad de vida (EQ-5D) al inicio y en las semanas 1 y 4 tras la administración de carboximaltosa férrica intravenosa. Los cambios en los desenlaces continuos y sus trayectorias longitudinales se estimaron mediante modelos de regresión lineal mixta (LMRM). Resultados: Cuarenta y un pacientes completaron el estudio. La distancia recorrida en el 6-MWT aumentó de 296 101 a 314 106 men la semana 1 (p<0,01), ya 325 ± 111 men la semana 4 (p < 0,01). La PGA, el cuestionario EQ-5D y la escala de fatiga de Piper mejoraron significativamente en la semana 4 respecto al Inicio (p<0,05), tras ajustes en las dos últimas variables. Los niveles de hemoglobina no aumentaron significativamente durante el seguimiento. Conclusiones: La administración intravenosa de carboximaltosa férrica se asoció con una mejora significativa a corto plazo en el test de marcha de 6 minutos en pacientes con ERC e DH La PGA, el EQ-5D y la escala de fatiga de Piper también mostraron mejoría a las 4 semanas. Estos hallazgos respaldan el papel de la deficiencia de hierro en el deterioro del rendimiento físico en pacientes con ERC. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Background: Iron deficiency (ID) is highly prevalent in chronic kidney disease (CKD) and it's associated with poorer quality of life (QoL) and functional capacity. Intravenous iron therapy is limited to CKD patients with ID and anemia to avoid/delay the need or reduce the dose of erythropoiesis-stimulating agents, according to guidelines. We hypothesized that treatment with IV iron in CKD patients with ID and borderline anemia may improve their physical performance and QoL, independently of its effects on hemoglobin. Methods: Prospective, single-arm study in CKD patients with ID and mild anemia. The 6-min walk test (6-MWT), Piper fatigue scale, Patient's global assessment (PGA) and QOL (EQ-5D) questionnaires were evaluated at baseline, and at weeks 1 and 4 after receiving IV ferric carboxymaltose. Changes in continuous endpoints and their longitudinal trajectories were estimated with linear mixed regression models (LMRMs). Results: Forty-one patients completed the study. The 6-MWT increased from 296 ± 101 m to 314 ± 106 m at week 1 (p < 0.01), and to 325 ± 111 meters at week 4 (p < 0.01). PGA, EQ-5D questionnaire and Piper Fatigue scale significantly improved at week 4 from baseline (p < 0.05), after adjustment in the last 2 variables. Hemoglobin levels did not increase significantly during the follow-up. Conclusions: IV ferric carboxymaltose (IV FCM) was associated with a significant short-term improvement in the 6-MWT in CKD patients with iron deficiency and mild anemia. PGA, EQ-5D and Piper Fatigue Scale also improved at 4 weeks. These findings suggest a potential short-term benefit of IV ferric carboxymaltose on physical performance and PROMs in this population, independent of hemoglobin changes; however, given the small sample size and absence of a control group, results should be interpreted with caution and considered hypothesis-generating. [ABSTRACT FROM AUTHOR]
ISSN:	02116995
DOI:	10.1016/j.nefro.2025.501418