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Abstract: SA-PO513

Relationship Between Iron Deficiency and QTc Prolongation in Japanese Maintenance Hemodialysis Patients

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Fujisaki, Kiichiro, Iizuka Hospital, Iizuka, Fukuoka, Japan
  • Sasaki, Sho, Kyoto University Hospital, Kyoto, Kyoto, Japan
  • Nakano, Toshiaki, Kyushu University, Fukuoka, Fukuoka, Japan
  • Joki, Nobuhiko, Toho University Ohashi Medical Center, Tokyo, Tokyo, Japan

QT interval prolongation is a risk factor for fatal arrhythmias and other cardiovascular complications. Causes of QT interval prolongation in hemodialysis (HD) patients is not fully understood. It has also recently been reported that lower transferrin saturation (TSAT), one of the marker for iron deficiency, is associated with cardiovascular complications in patients with CKD. We hypothesize that iron deficiency may be associated with QT interval prolongation in HD patients.


We identified 175,448 eligible patients from a nation-wide database receiving thrice-weekly HD in Japan. The cross-sectional study was conducted on adult maintenance HD patients enrolled in the 2019 Japanese Society for Dialysis Medicine Annual Survey. Logistic regression analysis was performed with serum ferritin (S-fer) and TSAT as explanatory variable and QTc prolongation (QTc >500 msec) as outcome, adjusted for possible confounding factoes.


A total of 175,448 patients were included in the analysis of this study. The mean QTc (standard deviation) was 451.7 (36.1) msec. 13,343 (7.6%) of subjects have suffered from QTc >500 msec. On multivariate analysis, the adjusted odds ratios [95% confidence interval] for QTc prolongation in the groups with TSAT ≤ 20% and S-Fer >100 ng/mL, TSAT ≤ 20% and S-Fer ≤ 100 ng/mL, TSAT > 20% and S-Fer ≤ 100 ng/mL with the group with S-Fer > 100 ng/mL and TSAT > 20% as the control group, were 1.12 [1.05, 1.20], 1.19 [1.14, 1.25] and 0.99 [0.95, 1.04], respectively. A J-curve relationship was observed between TSAT and QTc prolongation (Figure).


This study suggests that decreased TSAT (≤20%) may be associated with QTc prolongation in maintenance HD patients. Iron deficiency may play some role for prolonging ventricular repolarization time independent of other risks in HD patients.

A J-curve relationship was observed between TSAT and QTc prolongation