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Abstract: TH-PO253

Absolute Iron Deficiency, Coronary Artery Calcification, and Mortality in Dialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Usui, Koji, Iryohojin Ichiyokai Ichiyokai Clinic, Hiroshima, Japan
  • Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Japan
Background

It is reported that iron-deficiency is associated with hypercoagulability and stroke by upregulating transferrin (Tang X. Circ Res. 2020;127:651). We studied the associations among iron deficiency, coronary artery calcification and mortality in patients on dialysis.

Methods

We included 230 patients with predilution online hemodiafiltration and 76 on hemodialysis. The Agatston coronary artery calcium score (CACS) and clinical data, such as transferrin saturation (TSAT), ferritin, hemoglobin, mean corpuscular hemoglobin (MCH), serum albumin and C-reactive protein (CRP) at baseline, were assessed. Kaplan–Meier survival analyses and Cox proportional hazard models were used to assess patients’ survival. Logistic regression analyses were used to determine related factors for absolute iron deficiency (TSAT ≤20% and ferritin concentrations ≤100 ng/mL).

Results

In all patients (n=306), age, dialysis duration and diabetes prevalence were 65±12 years, 76 (38–142) months and 42.5%, respectively. During 3 years, 52 all-cause deaths and 34 cardiovascular (CV) deaths occurred. Patients with absolute iron deficiency (n=102) showed significantly lower TSAT (13%±4% vs 30%±10%) and ferritin (34±23 vs 109±96 ng/mL) and MCH (28±3 vs 32±2 pg) concentrations, but significantly higher CRP concentrations than patients without absolute iron deficiency (n=204) (P<0.05). Age, sex, dialysis duration, prevalence of diabetes and serum albumin concentrations were not significantly different according to the presence of absolute iron deficiency. Absolute iron deficiency was significantly related to the CACS (P<0.05). Patients with absolute iron deficiency had a significantly lower Kaplan–Meier survival rate for 3-year CV death than patients without absolute iron deficiency (82.2% vs 90.9%; log-rank test, P<0.05). However, there was no significant difference in survival for 3-year all-cause death between the two groups. After adjusting for age, sex, diabetes, dialysis duration, serum albumin, C-reactive protein and hemoglobin, absolute iron deficiency was a significant predictor for 3-year CV mortality (hazard ratio: 2.08, P<0.05), but not for 3-year all-cause mortality.

Conclusion

Absolute iron deficiency is a significant predictor for the CACS and CV mortality, but not for all-cause mortality in patients on dialysis.

Funding

  • Private Foundation Support