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Abstract: FR-PO830

Impact of Iron Status on Kidney Outcomes in Kidney Transplantation Patients

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Kim, Hyo Jeong, Yonsei University Health System, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Heo, Ga Young, Yonsei University Health System, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Kim, Kyung Won, Yonsei University Health System, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Koh, Hee Byung, Yonsei University Health System, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Yang, Jaeseok, Yonsei University Health System, Seodaemun-gu, Seoul , Korea (the Republic of)
Background

Dynamic changes occur in iron storage after kidney transplantation (KT). Recently, iron has been reported to play a crucial role in hemodynamics of the heart, infections, and the immune system, independently of anemia. However, there are insufficient studies on the impact of iron status on kidney functions in KT patients. In this study, we investigated the association of iron status and kidney outcomes in KT patients.

Methods

We analyzed data from the KoreaN cohort study for Outcome in patients With KT(KNOW-KT). Patients were excluded who met the following criteria: 1) subjects who did not follow-up for at least 1 year after KT, 2) subjects without ferritin or transferrin saturation (TSAT) level at 1 year after KT. Iron status were classified based on ferritin and TSAT level. Ferritin and TSAT were categorized to 3 groups, where 20%, 35% as reference points for the TSAT, and 100ng/mL, 300ng/mL for the ferritin, respectively. Based on the quartiles of ferritin and transferrin saturation at 1 year after KT, iron status was classified as “Iron replete”, “Iron deficiency”, “Functional iron deficiency”, “High iron”, and “non-classified”. Primary outcome was the composite outcome of graft failure and eGFR decline≥50%. Cox regression analysis was used to analyze the association of iron status with the primary outcome.

Results

A total of 895 patients were included in the final analysis. During median follow-up of 5.8 years, primary outcome occurred in 94 patients, with an incidence rate of 19.8 per 1,000 person-years. The risk of composite outcome was higher in the high TSAT groups (> 35%) compared to the TSAT in range of 20-35% group (adjusted HR 1.68, 95% CI 1.01-2.79). The high ferritin groups also showed a trend of increased risk of the composite outcome despite statistical insignificance. Moreover, high iron groups showed a trend of increased risk of the composite outcomes compared to iron replete group (adjusted HR 2.05, 95% CI 0.97-4.34).

Conclusion

High iron status with high TSAT levels increased the risk of graft failure and renal progression in KT patients.