WEDNESDAY, July 14, 2021 (HealthDay News) — For patients with nondialysis chronic kidney disease (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 online July 8 in the Journal of the American Society of Nephrology.

Murilo Guedes, M.D., Ph.D., from Pontificia Universidade Catolica do Parana in Curitiba, Brazil, and colleagues 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 nondialysis CKD from Brazil, France, the United States, and Germany. Hazard ratios for all-cause mortality and MACE were estimated using Cox models.

The researchers found that the highest adjusted risks for all-cause mortality and MACE were seen for patients with a TSAT ≤15 percent compared with those with a TSAT of 26 to 35 percent. The lowest risk for all-cause mortality and MACE was seen at TSAT 40 percent in a spline analysis. At TSAT ≥46 percent, 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, with the exception of an increase in all-cause mortality at ferritin ≥300 ng/mL.

“Intervention studies addressing the impact of iron deficiency treatment beyond its erythropoietic effects are necessary to challenge the anemia-focused paradigm of iron deficiency management in CKD, potentially fostering more optimal strategies for improving patient outcomes,” a coauthor said in a statement.

The work was partially funded by several pharmaceutical companies. Several authors disclosed financial ties to the pharmaceutical industry.

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