Iron Deficiency in Peritoneal Dialysis Population Tied With Early Death – Renal and Urology News

The death risk associated with iron deficiency in the chronic kidney disease population extends to patients on peritoneal dialysis, investigators reported at the 2024 World Congress of Nephrology in Buenos Aires, Argentina.

In a study of 11,302 patients starting peritoneal dialysis in the United States, those who had a transferrin saturation (TSAT) of 20% or less had a 30.2% increased risk for early mortality compared with those who had a normal TSAT value of 30%-40%, Roberto Pecoits-Filho, MD, PhD, of the DOPPS Program at Arbor Research Collaborative for Health in Michigan, and colleagues reported. The crude mortality rate for the low TSAT group was 198.8 deaths per 1000 patient years. The investigators found an excess mortality risk even after adjustment for demographics, ferritin, hemoglobin, intravenous iron use, treatment with erythropoiesis-stimulating agents, albumin, gastrointestinal bleeding, and comorbidities.

At baseline, the cohort had a mean age of 55 years. Mean TSAT was 31% and mean ferritin was 444 ng/mL. The vast majority (90%) had been treated with ESAs, but only 33% were receiving intravenous iron. Patients were categorized based on their mean TSAT values during the first 180 days of peritoneal dialysis: 20% or less, more than 20% to 30%, more than 30% to 40%, more than 40% to 50%, and more than 50%.

“Our results highlight the importance of evaluating [iron deficiency] in the incident [peritoneal dialysis] population, even in the absence of anemia,” Dr Pecoits-Filho’s team concluded.