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Abstract: SA-PO651

Profiles of Iron and Anemia Indices and Associations in Mental Health Among Incident Peritoneal Dialysis Patients in Brazil and the 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
  • Pecoits, Peter G., Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • 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

Management of iron stores and anemia are important to maintaining quality of life in dialysis, yet the associations in mental health are unknown in Peritoneal Dialysis (PD). We aimed to identify and describe the trends in KDQOL mental component summary (MCS) scores and cohort characteristics in patients starting PD in Brazil (BR) and the United States (US), with a focus on iron and anemia indices and related medication use.

Methods

Patients included data on adults who started PD between Dec 2004-Jan 2011, that had ≥1 TSAT, hemoglobin (Hgb), ferritin, and KDQOL result within the first 180 days of PD. We described the BR and US cohort characteristics based on the following MCS categories: ≤35, >35-≤40, >40-≤50, >50. Higher MCS scores show better mental health. This preliminary analysis is descriptive, and it does not include multivariable adjustments.

Results

In both cohorts (BR=2022 vs US=1657), age (mean age BR=57.3 vs US=55.6) and albumin levels were consistent (both 3.7 g/dL). The US cohort had fewer males (BR=45% vs US=54%) and more patients with a white race (BR=62% vs US=72%). TSAT levels and erythropoietin stimulating agent use were higher in the US vs BR (Figure). Lower MCS scores were associated with higher ferritin & TSAT levels in BR, though not observed in the US. Higher MCS scores were positively associated with IV iron use in the US, but not observed in BR. Younger patients showed the lowest MCS scores in the US, while the inverse was found in BR.

Conclusion

In this preliminary descriptive analysis, we found some unique profiles in iron and anemia markers associated with mental health outcomes. Although some of these findings may be related to practice patterns, iron and anemia management may potentially influence the mental health of patients at PD initiation. Further investigations are needed to understand this relationship and its implications for patient care and outcomes.

Funding

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