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Abstract: PO2302

Associations Between Serum Biomarkers of Iron Stores and the Progression to Kidney Failure in Patients with Moderate-to-Severe CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Calice-Silva, Viviane, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Muenz, Daniel G., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Stengel, Benedicte, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Raj, Dominic S., GWU Medical Faculty Associates, Washington, District of Columbia, United States
  • Reichel, Helmut, Nephrologisches Zentrum Villingen-Schwenningen, Villingen-Schwenningen, Germany
  • Waechter, Sandra, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Di Francesco, Tiziana, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

We recently reported that lower levels of biomarkers of iron stores are associated with a higher risk of all-cause mortality and major adverse cardiovascular events in patients with moderate to severe chronic kidney disease (CKD). However, the impact of these parameters on the risk of kidney failure (KF), potentially a competing risk, has not been previously explored.

Methods

Patients from Brazil, France, Germany and the US in CKDopps (eGFR <60 mL/min at enrollment, under nephrology care) and with available TSAT and ferritin levels were included in the analyses. Cox models were used to estimate hazard ratios (HR) for the outcome of KF (defined as a composite endpoint including dialysis initiation, transplant, 40% decline of eGFR from baseline, or sustained eGFR <15 mL/min/1.73m2).

Results

A total of 5,431 patients were evaluated (Brazil=337, France=2231, Germany=2112, US=751), mean eGFR 28±11mL/min/1.73m2. Over median follow-up time of 2.0 [0.6-3.0] years, there were 1800 (33%) KF events (15.7/100 pt-years). TSAT had a U-shaped association with KF (with highest HR at TSAT<15%) in the crude analysis (Model 1 of Table 1). Neither TSAT nor ferritin had a directional association with KF after adjustment for confounders (Model 2).

Conclusion

Levels of biomarkers of iron stores, as captured by TSAT and/or ferritin, are not associated with development KF in patients with moderate to severe CKD under nephrology care. These findings further the understanding of our previous finding of a higher risk of mortality and cardiovascular events in this population with iron deficiency and high risk of CKD progression.

Funding

  • Commercial Support