Karuna Kumar: Busting the Myth about Increasing Infection Risk by IV Iron
Karuna Kumar, Senior Consultant at Yashoda Hospitals, shared a post on LinkedIn about a recent article by Paul W. Foley et al, published in European Journal of Heart Failure, adding:
“One concern I hear from colleagues about IV iron:
‘Doesn’t it increase infection risk? Iron feeds bacteria.’
Fair question. The theory makes sense. Iron is essential for bacterial growth. Give IV iron, maybe you’re feeding pathogens.
The IRONMAN trial just addressed this directly.
They looked at heart failure patients who received IV ferric derisomaltose vs standard care. Specifically tracked serious infections.
The finding?
No increased infection risk.
In fact, there was a trend toward fewer infections in the IV iron group. Not statistically significant, but certainly not worse.
The explanation:
Correcting iron deficiency actually improves immune function. Iron-deficient patients are more susceptible to infections, not less.
My practice hasn’t changed. I’ve been comfortable with IV iron for years. But now I have better data to share with patients who ask.
Based on current evidence, the infection concern appears to be theoretical rather than clinical. More data from other populations will help confirm.
Source:
Eur J Heart Fail 2025 (IRONMAN trial)”
Title: Effect of Correcting Iron Deficiency on the Risk of Serious Infection in Heart Failure: Insights from the IRONMAN Trial
Authors: Paul W. Foley, Paul R. Kalra, John G.F. Cleland, Mark C. Petrie, Philip A. Kalra, Ian Squire, Philip Campbell, Callum Chapman, Patrick Donnelly, Fraser Graham, Andrew Hannah, Ninian N. Lang, Iain Matthews, Stephen J. Leslie, Pierpaolo Pellicori, Sue Piper, Robin Ray, Hernry O. Savage, Chales Spencer, John Walsh, Yuk-Ki Wong, Ian Ford
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