Would you opt to start IV iron load, maintenance iron therapy, or no iron at all in a patient with ESKD on hemodialysis who has a stable hemoglobin level at around 12.0 g/dL but also has low iron stores as evidenced by a low transferrin saturation and ferritin?

I routinely give an IV iron load to such patients. Iron is required for metabolic functions other than hemoglobin production and, for example, studies in non-anemic iron-deficient patients with heart failure consistently demonstrate improved outcomes with IV iron administration. If the patient is no...

I would hold off on giving IV iron to this patient. If iron deficiency worsens enough for them to drop their hemoglobin to lower than 11 g/dL, then I would give IV iron. Oral iron would work well in these patients but I would rather avoid the constipation that comes with it.

Depends on how low, if on an ESA.