Low TSAT Predicts Worse Outcomes in Anemic Dialysis Patients

ATLANTA—Low transferrin saturation (TSAT) is an independent risk factor for adverse clinical outcomes in dialysis patients with anemia, according to data presented at the American Society of Nephrology's Kidney Week 2013 meeting.

Researchers at Yonsei University in Seoul, Korea, enrolled 879 anemic dialysis patients and divided them into three groups based on their baseline TSAT (20% or less, 20%-40%, and greater than 40%). The three groups did not differ with respect to hemoglobin levels and the proportion of patients on erythropoiesis stimulating agents or iron supplements.

During a mean follow-up period of 19.3 months, 51 patients (5.8%) died. Cardiovascular deaths or hospitalizations (CV composite outcome) occurred significantly more frequently among patients with a TSAT of 20% or less than in those with a TSAT of 20%-40% (reference group): 11.71 vs. 5.55 events/100 patient-years. Significantly more patients with a TSAT of 20% or less than in the reference group died from any cause: 5.38 vs. 2.31 events/100 patient-years.

Additional analysis showed that patients with a TSAT of 20% or less had a 1.6 and 2.2 times increased risk of the CV composite outcome and all-cause mortality compared with the reference group. A TSAT of 20% or less independently predicted a 46% increased risk of left ventricular hypertrophy.

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