The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.

ABSTRACT:

Background

The prognostic importance of anemia for cardiovascular (CV) events and mortality has been extensively investigated. However, little is known about the impact of transferrin saturation (TSAT), a marker reflecting the availability of iron for erythropoiesis, on clinical outcome in dialysis patients.

Methods

A total of 879 anemic incident dialysis patients were recruited from the Clinical Research Center for End-Stage Renal Disease in Korea and were divided into 3 groups according to baseline TSAT of ?20%, 20-40%, and >40%.

Results

There were no differences in hemoglobin levels and the proportion of patients on erythropoiesis-stimulating agents or iron supplements among the 3 groups. During a mean follow-up duration of 19.3 months, 51 (5.8%) patients died. CV composite (11.71 vs. 5.55 events/100 patient-years, P?=?0.001) and all-cause mortality rates (5.38 vs. 2.31 events/100 patient-years, P?=?0.016) were significantly higher in patients with TSAT ?20% compared to those with TSAT 20-40% (reference group). Cox regression analysis revealed that patients with TSAT ?20% had 1.62- and 2.19-fold higher risks for CV composite outcome (P?=?0.046) and all-cause mortality (P?=?0.030). Moreover, TSAT ?20% was significantly associated with left ventricular hypertrophy [odds ratio (OR) ?=?1.46], high-sensitivity C-reactive protein ?3 mg/dL (OR?=?2.09), N-terminal pro B-type natriuretic peptide ?10000 pg/mL (OR ?=?2.04), and troponin-T?0.1 ng/mL (OR ?=?2.02), on logistic regression analysis.

Conclusions

Low TSAT was a significant independent risk factor for adverse clinical outcome in incident dialysis patients with anemia, which may be partly attributed to cardiac dysfunction and inflammation.

SUBMITTER: Koo HM 

PROVIDER: S-EPMC3914817 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature