Macdougall IC, Bhandari S, White C, et al. - In view of the data from experimental and observational studies raising concerns that intravenous (IV) iron might increase the risk of infections, researchers conducted a prespecified secondary analysis of the Proactive IV Iron Therapy in Haemodialysis Patients (PIVOTAL) trial to determine infection rates among 2,141 randomized patients who were undergoing maintenance hemodialysis for ESKD and were randomized to a high-dose or a low-dose IV iron regimen. No differences were observed in incidence of infection, hospitalization for infection, or death from infection between high-dose and low-dose IV iron groups. The PIVOTAL trial established the potential cardiovascular benefits of higher-dose IV iron (due to either a direct effect of the IV iron or a decreased use of erythropoiesis-stimulating agents and thus, less exposure to associated cardiotoxic effects). Outcomes of this analysis provides reassurance for providing higher doses of IV iron than are currently given in many units worldwide. A strong correlation was observed between the risk of a first cardiovascular event and a recent infection.