The Association between Iron Deficiency and Renal Outcomes Is Modified by Sex and Anemia in Patients with Chronic Kidney Disease Stage 1-4

• Published in: Journal of personalized medicine Vol. 13; no. 3; p. 521
• Main Authors: Yu, Pei-Hua, Chao, Yu-Lin, Kuo, I-Ching, Niu, Sheng-Wen, Chiu, Yi-Wen, Chang, Jer-Ming, Hung, Chi-Chih
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.03.2023; MDPI
• Subjects: Analysis; Anemia; Blood pressure; Body mass index; Care and treatment; Chronic kidney failure; Creatinine; Health aspects; Heart failure; Hemodialysis; Hemoglobin; Hospitals; Inflammation; Instrument industry; Iron; Iron deficiency; Iron deficiency anemia; Kidney diseases; Laboratories; Malnutrition; Nutrient deficiency; Patient outcomes; Precision medicine; Renal function; Sensitivity analysis; Uric acid; Women; Womens health; United States; Taiwan; United States > US; transferrin saturation; iron; chronic kidney disease; renal outcomes; anemia; sex
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm13030521

Iron deficiency is prevalent in women and patients with chronic kidney disease (CKD). Iron deficiency is not only related to anemia but contributes to adverse consequences for the kidney as well. Whether iron status is associated with renal outcomes after considering sex and anemia in patients with CKD stage 1-4 is unclear. Thus, we investigated the association of iron or iron saturation with renal outcomes in a CKD cohort. During a follow-up of 8.2 years, 781 (31.2%) patients met the composite renal outcome of renal replacement therapy and a 50% decline in renal function. In linear regression, iron was associated with sex, hemoglobin (Hb), and nutritional markers. In a fully adjusted Cox regression model, the male patients with normal iron had a significantly decreased risk of renal outcomes (hazard ratio (HR) 0.718; 95% confidence interval (CI) 0.579 to 0.889), but the female patients did not exhibit this association. The non-anemic patients (Hb ≥ 11 g/dL) had a decreased risk of renal outcomes (HR 0.715; 95% CI 0.568 to 0.898), but the anemic patients did not. In the sensitivity analysis, transferrin saturation (TSAT) showed similar results. When comparing iron and TSAT, both indicators showed similar prognostic values. In conclusion, iron deficiency, indicated by either iron or iron saturation, was associated with poor renal outcomes in the male or non-anemic patients with CKD stage 1-4.