Kidney Week

Abstract: TH-PO677

Iron Deficiency Is More Common in Incident Peritoneal Dialysis Patients Without Anemia

Session Information

• Anemia and Iron Metabolism
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Hartley, Brianna, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Brianna Hartley,

• Rigodon, Vladimir, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Vladimir Rigodon,

• Larkin, John W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

John W. Larkin,

• Jiao, Yue, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Yue Jiao,

• Usvyat, Len A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Len A. Usvyat,

• Maddux, Franklin W., Fresenius Medical Care AG & Co KGaA, Bad Homburg, Hessen, Germany

Franklin W. Maddux,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

• Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Roberto Pecoits-Filho,

• Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Thyago Proença de Moraes,

• Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Murilo Henrique Guedes,

Background

Iron deficiency (ID) and anemia often coexist. Recent findings showed ID associates with mortality in chronic kidney disease (CKD), irrespective of anemia (Guedes, et al JASN 2021). Functional ID appears to confer higher risks for negative outcomes versus absolute ID in CKD. ID states and associated outcomes are uncertain in dialysis, particularly in peritoneal dialysis (PD). We aimed to characterize ID states and all-cause mortality rates in incident PD.

Methods

We used data from BRAZPD, an adult PD cohort across 122 clinics in Brazil (2004-2011) and included incident PD patients who had ≥1 transferrin saturation (TSAT), ferritin, and hemoglobin (hgb) lab during baseline (≤6 months after PD start). We defined prevalence of ID (i.e. TSAT <20%), patient characteristics, and crude mortality rates per 1000 patient years (p1000py) by ID states: 1. functional ID: (hgb ≥10 g/dL, TSAT <20%, ferritin ≥200 ng/mL), 2. functional ID with anemia: (hgb <10 g/dL, TSAT <20%, ferritin ≥200 ng/mL), 3. absolute ID (hgb ≥10 g/dL, TSAT <20%, ferritin <200 ng/mL), and 4. absolute ID with anemia (hgb <10 g/dL, TSAT <20%, ferritin <200 ng/mL).

Results

Among a cohort of 1,365 incident PD patients (mean age 59.7 years, 46.4% male, 49.1% diabetes), the prevalence of ID was 14.9% (n=203). Prevalence of ID states was 5.2% for functional ID, 1.5% for functional ID with anemia, 6.3% for absolute ID, and 1.8% for absolute ID with anemia (Figure 1). The mortality rate was observed to be the highest for functional ID at 195.6 deaths p1000py, as compared to other ID states.

Conclusion

In incident PD, we found a 14.9% prevalence of ID; most patients had ID without anemia. This finding may be of importance given screening for ID is recommended with low hgb. Anemic patients were infrequently iron deficient, which may suggest more active iron replacement triggered by low hgb. Incident PD patients with functional ID without anemia appeared to exhibit a higher all-cause mortality rate than other ID states. Further studies are needed to confirm these findings.

Funding

• Commercial Support –