For patients with non-dialysis CKD, with or without anemia, iron deficiency as reflected by a serum biomarker of iron stores is associated with an increased risk for all-cause mortality and major adverse cardiovascular events (MACE), according to a study published in the Journal of the American Society of Nephrology. Researchers examined the association between serum biomarkers of iron stores (transferrin saturation [TSAT] and ferritin levels) and all-cause mortality and cardiovascular event risks among 5,145 patients with non- dialysis CKD from the United States and other countries. Hazard ratios for all-cause mortality and MACE were estimated using Cox models. The highest adjusted risks for all-cause mortality and MACE were seen for patients with a TSAT less than or equal to 15% compared with those with a TSAT of 26% to 35%. The lowest risk for all-cause mortality and MACE was seen at TSAT 40% in a spline analysis. At TSAT greater than or equal to 46%, the risk for all-cause mortality, but not MACE, also was elevated. After adjustment for hemoglobin, the effect estimates were similar. For ferritin, there were no directional associations, except for an increase in all-cause mortality at ferritin greater than or equal to 300 ng/mL. “In- tervention studies addressing the impact of iron deficiency treatment beyond its erythropoietic effects are necessary to challenge the anemia- focused paradigm of iron deficiency manage- ment in CKD, potentially fostering more optimal strategies for improving patient outcomes,” a co- author said in a statement.