Absolute or functional iron deficiency — even without anemia — is associated with worse health-related quality of life (HRQOL) in patients with nondialysis-dependent chronic kidney disease (ND-CKD), according to investigators presenting at the American Society of Nephrology’s Kidney Week 2020 Reimagined virtual conference.

Using Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) data from the United States, France, and Brazil, Murilo H. Guedes, MD, MSc, of Pontifical Catholic University of Parana, Curitiba, PR, Brazil, and collaborators studied iron deficiency in approximately 2500 patients with stage 3b to 5 CKD. Patients had a mean age of 67 years and a mean hemoglobin (Hb) level of 12.6 dL, transferrin saturation (TSAT) of 26%, and ferritin level of 196 ng/mL. Heart failure was present in 14% of the cohort.

TSAT of 15% or less, high ferritin (300 ng/mL or more), and low ferritin (less than 50 ng/mL) each was associated with worse scores on the physical component summary of the KDQOL-36 but not on the mental component summary or a depression index. Patients with both TSAT of 15% or less and ferritin level of 300 ng/mL or more, for example, had lower functionality scores and a worse physical component summary compared with patients with normal TSAT of 20% to 30% and ferritin of 50 to 299 ng/mL. Results were similar for patients with Hb lower or higher than 11.5 g/dL.

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“Randomized controlled trials assessing iron deficiency correction beyond the traditional erythropoeitic-focused goal are warranted in ND-CKD patients, including key patient-reported outcomes,” Dr Guedes and colleagues concluded.

Disclosure: This clinical trial was supported by Vifor Pharma. Please see the original reference for a full list of authors’ disclosures.


Guedes MH, Muenz DG, Zee J, et al. Lower transferrin saturation (TSAT) is associated with worse health-related quality of life (HRQOL) in non-dialysis CKD (NDD-CKD) patients independently from hemoglobin (Hb) levels. Presented at: Kidney Week 2020 Reimagined, October 19-25, 2020. Poster PO0281.