Abstract: SA-PO239
Prevalence, Correlates, and Outcomes of Absolute and Functional Iron Deficiency Anemia in Non-Dialysis-Dependent CKD
Session Information
- Anemia and Iron Metabolism: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 202 Anemia and Iron Metabolism: Clinical
Authors
- Awan, Ahmed A., Baylor college of medicine , Houston, Texas, United States
- Walther, Carl P., Baylor College of Medicine, Sugar Land, Texas, United States
- Richardson, Peter, Baylor College of Medicine, Sugar Land, Texas, United States
- Winkelmayer, Wolfgang C., Baylor College of Medicine, Sugar Land, Texas, United States
- Navaneethan, Sankar D., Baylor College of Medicine, Sugar Land, Texas, United States
Background
Anemia contributes to adverse outcomes in those with chronic kidney disease (CKD). We examined the association of absolute and functional iron deficiency anemia (IDA) with adverse outcomes (hospitalization, dialysis and mortality) in those with CKD.
Methods
Non-dialysis patients followed in the Veterans Administration with hemoglobin level measured within 90 days of the date of the second eGFR < 60 ml/min/1.73m2 were included. Logistic regression, multivariate Cox proportional hazard and poisson regression models adjusted for demographics and comorbidities were used to assess following outcomes: a) prevalence and correlates of absolute (TSAT < 20%, ferritin <100ng/ml), functional IDA (TSAT < 20%, ferritin 100-800 ng/ml) and b) association of absolute and functional IDA, those with Ferritin >800 ng/ml with mortality, dialysis and cardiovascular hospitalization.
Results
Out of 933,463 CKD patients included, 21.6% were anemic. Among patients with anemia with TSAT/Ferritin data, 50% did not have iron deficiency, 30% had absolute IDA, and 19% had functional IDA. Median follow-up was 3.9 years for mortality and 3.6 years for dialysis. Absolute IDA was not associated with an increased risk of mortality and dialysis but had higher risk of 1-year (RR 1.18, 95% CI: 1.11-1.26) and 2-year cardiovascular hospitalization (RR 1.10, 95% CI: 1.04-1.16) [FIGURE]. CKD patients with functional IDA had a higher risk of mortality along with a higher risk of 1-year and 2-year cardiovascular hospitalization. Ferritin > 800 ng/ml (treated as a separate category) was only associated with an increased risk of mortality.
Conclusion
In a large population of CKD patients with anemia, functional IDA was associated with higher risk of mortality and cardiovascular hospitalization while absolute IDA was associated with a higher risk of hospitalization.
Funding
- Commercial Support – Keryx Biopharmaceuticals