Serum biomarkers of iron stores are associated with worse physical health-related quality of life (HRQoL) in non-dialysis dependent chronic kidney disease (NDD-CKD) patients with or without anemia.

ABSTRACT:

Background

Iron deficiency (ID) is a common condition in non-dialysis dependent chronic kidney disease (NDD-CKD) patients that is associated with poorer clinical outcomes. However, the effect of ID on health-related quality of life (HRQoL) in this population is unknown. We analyzed data from a multinational cohort of NDD-CKD stage 3 to 5 patients to test the association between transferrin saturation index (TSAT) and ferritin with HRQoL.

Methods

Patients from Brazil (N = 205), France (N = 2015), and the US (N = 293) in the CKD Outcomes and Practice Patterns Study (CKDopps, 2013 to 2019) were included. We evaluated the association of TSAT and ferritin (and functional and absolute ID, defined as TSAT ≤ 20% and ferritin >300 or < 50 ng/mL, respectively) on pre-specified HRQoL measures, including KDQOL-36 PCS and MCS as the primary outcomes. Models were adjusted for confounders including hemoglobin (Hgb).

Results

TSAT ≤15% and both ferritin <50 ng/mL and ≥300 ng/mL were associated with worse PCS scores, but not with MCS. Patients with composite TSAT ≤20% and ferritin <50 or ≥ 300 ng/mL had lower functional status and worse PCS than those with TSAT of 20%-30% and ferritin 50-299 ng/mL. Patients with lower TSAT were less likely to perform intense physical activity. Adjustment for Hgb only slightly attenuated the observed effects.

Conclusions

Low TSAT levels, as well as both low TSAT with lower ferritin and low TSAT with high ferritin, are associated with worse physical HRQoL in NDD-CKD patients, even after accounting for Hgb level. Interventional studies of iron therapy on HRQoL among NDD-CKD individuals are needed to confirm these findings.

SUBMITTER: Guedes M 

PROVIDER: S-EPMC8396397 | biostudies-literature |

REPOSITORIES: biostudies-literature