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Background  Although the efficacy of iron sucrose (IS) and ferric carboxymaltose (FCM) in treating anemia in hemodialysis (HD) patients has been studied individually, a comparison of these two intravenous iron formulations has not yet been performed in HD patients.    Methods  We performed a retrospective audit on records of 221 stable HD patients from different HD centers in the Netherlands, who were switched from IS to FCM on a 1:1 ratio. To assess the effect of the switch on iron status parameters, data from 3 time points before and 3 time points after the switch were analyzed using linear mixed effects models. Subanalyses were done in 2 subgroups of patients anemic or iron deficient at baseline.    Results  Hemoglobin increased in all groups (anemic [1.4 g/dL,  P  < 0.001] iron deficient [0.6 g/dL,  P  < 0.001]), while the weekly iron dose was significantly lower when patients received FCM compared to IS (48 vs 55 mg/week,  P  = 0.04). Furthermore, serum ferritin and transferrin saturation increased in all groups (anemic [64 μg/L, 5.0%,  P  < 0.001] iron deficient [76 μg/L, 3.6%,  P  < 0.001]). Finally, the darbepoetin α dose decreased significantly in all groups (anemic [− 16 μg/wk.,  P  = 0.01] iron deficient [− 11 μg/wk.,  P  < 0.001]).    Conclusions  In this real-life study in HD patients, a switch from IS to FCM resulted in an improvement of iron status parameters despite a lower weekly dose of FCM. Furthermore, the ESA dose was reduced during FCM, while hemoglobin levels increased.    Electronic supplementary material  The online version of this article (10.1186/s12882-018-1045-8) contains supplementary material, which is available to authorized users.

Switching iron sucrose to ferric carboxymaltose associates to better control of iron status in hemodialysis patients