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Abstract: FR-PO832

Impact of Transferrin Saturation on All-Cause Mortality in Patients on Maintenance Hemodialysis

Session Information

Category: Dialysis

  • 702 Dialysis: Home Hemodialysis


  • Nitta, Kosaku, Tokyo Women's Medical University, Shinjuku-ku, ToKyo, Japan

To evaluate iron status, transferrin saturation (TSAT) and serum ferritin levels are commonly used. TSAT provides an assessment of how much transferrin has bound iron, whereas serum ferritin is a marker used to reflect body iron storage. Our aim was to evaluate the prognostic importance of TSAT in Japanese patients on maintenance hemodialysis (MHD).


A total of 398 MHD patients were recruited and divided into 3 groups according to baseline TSAT of <20%, 20–40%, and >40%. The mean duration of the study was 52.2 ± 16.3 months. The primary endpoint was all-cause mortality, and the secondary endpoint was cardiovascular (CV) mortality.


A total of 130 patients died during a mean follow-up duration of 52.2 ± 16.3 months. There were no differences in the proportion of patients on erythropoiesis-stimulating agents or iron supplements among the 3 groups. During a mean follow-up duration of 52.2 ±1 6.3 months, 130 patients died of CV causes (n = 63, (15.8%) and infection (n = 47, 11.8%). Compared with the reference group (TSAT 20–40%), patients with TSAT <20% had significantly higher all-cause mortality rates (6.44 vs. 9.55 events per 100 patient-year, p = 0.0452). Kaplan-Meier analysis also showed that all-cause mortality rates were significantly higher in patients with TSAT <20% compared to the other two groups (p =0.0353).


Low TSAT was a significant independent risk factor for all-cause mortality in a cohort of Japanese MHD patients. These findings suggested that the adverse clinical outcomes in patients with low TSAT can be partly attributed to iron-deficiency anemia.