ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Erythropoietic response to oral iron with sodium-glucose co-transporter 2 inhibitors.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Glucose Transporters: Structure, Trafficking, Physiology, and Disease Relevance.Current issues in molecular biology · 2026Review
- KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD): a commentary from the European Renal Best Practice (ERBP).Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnemia and iron deficiency are common in heart failure (HF) and chronic kidney disease (CKD). These conditions are associated with upregulation of hepcidin, which impairs the enteric absorption of iron, limiting the use of oral iron formulations in these populations. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are associated with enhanced erythropoiesis and have been shown to augment the erythropoietic response to intravenous iron. The effect of baseline SGLT2i therapy in the erythropoietic response following oral iron supplementation is currently not known.
objectivesTo compare the erythropoietic response to oral iron supplementation in patients with HF or CKD, using and not using SGLT2i as background therapy.
methodsThis is a retrospective analysis of ambulatory patients with HF or CKD followed in cardio-kidney-metabolic clinics from a quaternary care hospital in Canada and a tertiary care hospital from Portugal. An age- and sex-matched population of patients using (n = 76) and not using (n = 76) a SGLT2i was compared for changes in hemoglobin and hematocrit following oral iron supplementation. Secondary outcomes included changes in iron biomarkers, natriuretic peptides and kidney function.
resultsOverall, the mean age was 75 ± 9 years, 49% were men, 119 (78%) had CKD, 107 (70%) HF, and 113 (74%) had anemia. After adjustment for baseline differences, SGLT2i users experienced a greater increase in hemoglobin and hematocrit compared to SGLT2i non-users: hemoglobin + 0.80 g/dL (95% confidence interval [CI] 0.39-1.21 g/dL, p < 0.001); hematocrit + 3.0% (95% CI 1.0-4.0%, p < 0.001). No significant differences on iron biomarkers or any of the secondary outcomes were found between the groups.
conclusionsOral iron supplementation in patients with background therapy including a SGLT2i (vs. SGLT2i non-users) was associated with a greater increase in hemoglobin and hematocrit. These results suggest that patients with HF or CKD patients treated with SGLT2i might have an enhanced erythropoietic response to oral iron supplementation.
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