Breaking the Cycle in Cardiorenal Anemia Syndrome: The Practice-changing Role of IV Iron at the CKD–Heart Failure Interface

• Evaluate the fundamental facets of the “pathologic triad” in cardiorenal anemia syndrome (CRAS), with a particular focus on the multifaceted effects of concomitant anemia on chronic kidney disease (CKD) and heart failure (HF) disease progression.
• Describe proposed mechanisms of interrelationship between non–dialysis-dependent chronic kidney disease (NDD-CKD), heart failure (HF), and anemia, with a renewed emphasis on the pathophysiologic impact of iron deficiency (ID).
• Discuss the basic tenets of iron metabolism and absorption in NDD-CKD and HF, including the essential utility of serum ferritin and TSAT as diagnostic laboratory indices for ID and iron deficiency anemia (IDA) assessment and treatment decisions.
• Appraise completed, ongoing, and planned clinical trials establishing the safety and efficacy of IV iron therapies for ID/IDA in both NDD-CKD and HF, and identify pivotal data readouts that have influenced current practice and consensus guidelines.
• Investigate the emerging clinical potential of IV iron to safely and effectively treat anemia of CRAS and, thereby, reduce the progression of both NDD-CKD and HF and optimize patient outcomes across the continuum.
• Examine IV iron as a therapeutic adjunct/alternative to erythropoiesis-stimulating agents (ESAs) for patients with CRAS.
• Identify how the innovative nanoparticle design of next-generation IV iron agents dramatically improves upon the safety profiles of older generation products, with anaphylaxis and severe hypersensitivity rates as low as 0.1%.
• Use a real-world, case-based format to analyze how CRAS inflammatory molecular signatures and elevated hepcidin levels impact the comparative clinical utility of oral vs IV iron supplementation modalities for ID/IDA management in NDD-CKD and HF.
• Compare and contrast currently FDA-approved IV iron products, including approved indications and practical clinical differentiators, such as the capacity for total dose infusions (TDI).
• Design iron repletion treatment plans for patients with CRAS using innovative, evidence-supported clinical tools, such as diagnostic algorithms, integrated digital checklists, and Ganzoni’s formula.

Supported through an independent educational grant from American Regent.

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Planner/Faculty:
Matthew R. Weir, MD–has disclosed that he is an advisor or consultant to Akebia, AstraZeneca, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Janssen, Merck, Novo Nordisk, and Vifor Pharma.

Faculty:
Javed Butler, MD, MPH, MBA–has disclosed that he is on the speaker’s bureau for AstraZeneca, Boehringer lngelheim, Lilly, Janssen, and Novartis. He is also a consultant to Abbott, Adrenomed, Amgen, Applied Therapeutics, Array, AstraZeneca, Bayer, Boehringer lngelheim, Bristol Myers Squibb, CVRx, G3 Pharmaceutical, Impulse Dynamics, lnnolife, Janssen, Luitpold, Medtronic, Merck, Novartis, Novo Nordisk, Relypsa, Roche, UvaNova, and Vifor.
Peer Reviewer:
Donna S. Hanes, MD–has no relevant financial relationships to disclose in relation to the content of this activity.

CEC Staff:
Bryan C. Taylor, PharmD–has no relevant financial relationships to disclose in relation to the content of this activity.
Jessica Hall–has no relevant financial relationships to disclose in relation to the content of this activity.

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. CEC, the faculty, and any commercial supporter of this activity do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.