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Kidney Week

Abstract: SA-PO652

Higher Iron Deficiency Rates Among Incident Peritoneal Dialysis Patients Without Anemia in Brazil and United States

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Rigodon, Vladimir, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Hartley, Brianna, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Pecoits, Peter G., Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Neri, Luca, Fresenius Medical Care, Cremona, Italy
  • Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Kooman, Jeroen, Maastricht University Medical Center, Maastricht, Netherlands, Netherlands
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
Background

The profiles of iron deficiency (ID) are undefined in the peritoneal dialysis (PD) population. This study examines the prevalence of and patient characteristics associated with ID states and the coexistence of anemia in incident PD patients in the United States (US) and Brazil (BR).

Methods

We used data from adults starting PD at 122 clinics in BR and >2500 clinics in the US. We included patients who had at least ≥1 hemoglobin (Hgb), ferritin, and transferrin saturation (TSAT) measurement within 180 days of PD start. ID was defined as TSAT <20%. ID states were categorized as: a. functional ID, no anemia (TSAT <20%, ferritin ≥200 ng/mL, Hgb ≥10 g/dL), b. functional ID with anemia (TSAT <20%, ferritin ≥200 ng/mL, Hgb <10 g/dL), c. absolute ID, no anemia (TSAT <20%, ferritin <200 ng/mL, Hgb ≥10 g/dL), and d. absolute ID with anemia (TSAT <20%, ferritin <200 ng/mL, Hgb <10 g/dL).

Results

Patients starting PD in BR (n=1,365) and the US (n=12,303) had mean age of 59.8 (BR) & 55.2 (US) years, 46.4% (BR) & 55% (US) were male, 61% (BR) & 70% (US) were of a white race. ID was present in >10% of incident PD patients, with a slightly higher prevalence in BR (~4 percentage points). Rates of ID states were relatively consistent in BR and US for functional and absolute ID in patients without anemia, and these represent ≥80% of all ID cases (Figure 1). However, functional and absolute ID rates among patients with uncontrolled anemia were ≥3 fold higher in BR vs US.

Conclusion

Prevalence of ID at PD start is >10.6% and ID primarily exists in patients without anemia in both BR and US. Current recommendations suggest ID screening in patients with low Hgb, considerations that may be having implications on patient care. For instance, patients with functional ID had mean ferritin >400 ng/mL, yet levels were >150 ng/mL higher in those with vs without anemia. Ongoing research is underway to understand the trajectories and outcomes associated with ID in PD.

Funding

  • Commercial Support – Pontificia Universidade Catolica do Parana, Fresenius Medical Care, BaxterHealthcare