The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.

<h4>Background</h4>The prognostic importance of anemia for cardiovascular (CV) events and mortality has been extensively investigated. However, little is known about the impact of transferrin saturation (TSAT), a marker reflecting the availability of iron for erythropoiesis, on clinical...

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Autores principales:	Hyang Mo Koo, Chan Ho Kim, Fa Mee Doh, Mi Jung Lee, Eun Jin Kim, Jae Hyun Han, Ji Suk Han, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo, Shin-Wook Kang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae8938ddab6945369c2cb89482a1467c
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spelling	oai:doaj.org-article:ae8938ddab6945369c2cb89482a1467c2021-11-18T08:33:46ZThe relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.1932-620310.1371/journal.pone.0087231https://doaj.org/article/ae8938ddab6945369c2cb89482a1467c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24505281/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The prognostic importance of anemia for cardiovascular (CV) events and mortality has been extensively investigated. However, little is known about the impact of transferrin saturation (TSAT), a marker reflecting the availability of iron for erythropoiesis, on clinical outcome in dialysis patients.<h4>Methods</h4>A total of 879 anemic incident dialysis patients were recruited from the Clinical Research Center for End-Stage Renal Disease in Korea and were divided into 3 groups according to baseline TSAT of ≤20%, 20-40%, and >40%.<h4>Results</h4>There were no differences in hemoglobin levels and the proportion of patients on erythropoiesis-stimulating agents or iron supplements among the 3 groups. During a mean follow-up duration of 19.3 months, 51 (5.8%) patients died. CV composite (11.71 vs. 5.55 events/100 patient-years, P = 0.001) and all-cause mortality rates (5.38 vs. 2.31 events/100 patient-years, P = 0.016) were significantly higher in patients with TSAT ≤20% compared to those with TSAT 20-40% (reference group). Cox regression analysis revealed that patients with TSAT ≤20% had 1.62- and 2.19-fold higher risks for CV composite outcome (P = 0.046) and all-cause mortality (P = 0.030). Moreover, TSAT ≤20% was significantly associated with left ventricular hypertrophy [odds ratio (OR) = 1.46], high-sensitivity C-reactive protein ≥3 mg/dL (OR = 2.09), N-terminal pro B-type natriuretic peptide ≥10000 pg/mL (OR = 2.04), and troponin-T≥0.1 ng/mL (OR = 2.02), on logistic regression analysis.<h4>Conclusions</h4>Low TSAT was a significant independent risk factor for adverse clinical outcome in incident dialysis patients with anemia, which may be partly attributed to cardiac dysfunction and inflammation.Hyang Mo KooChan Ho KimFa Mee DohMi Jung LeeEun Jin KimJae Hyun HanJi Suk HanHyung Jung OhJung Tak ParkSeung Hyeok HanTae-Hyun YooShin-Wook KangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e87231 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyang Mo Koo Chan Ho Kim Fa Mee Doh Mi Jung Lee Eun Jin Kim Jae Hyun Han Ji Suk Han Hyung Jung Oh Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
description	<h4>Background</h4>The prognostic importance of anemia for cardiovascular (CV) events and mortality has been extensively investigated. However, little is known about the impact of transferrin saturation (TSAT), a marker reflecting the availability of iron for erythropoiesis, on clinical outcome in dialysis patients.<h4>Methods</h4>A total of 879 anemic incident dialysis patients were recruited from the Clinical Research Center for End-Stage Renal Disease in Korea and were divided into 3 groups according to baseline TSAT of ≤20%, 20-40%, and >40%.<h4>Results</h4>There were no differences in hemoglobin levels and the proportion of patients on erythropoiesis-stimulating agents or iron supplements among the 3 groups. During a mean follow-up duration of 19.3 months, 51 (5.8%) patients died. CV composite (11.71 vs. 5.55 events/100 patient-years, P = 0.001) and all-cause mortality rates (5.38 vs. 2.31 events/100 patient-years, P = 0.016) were significantly higher in patients with TSAT ≤20% compared to those with TSAT 20-40% (reference group). Cox regression analysis revealed that patients with TSAT ≤20% had 1.62- and 2.19-fold higher risks for CV composite outcome (P = 0.046) and all-cause mortality (P = 0.030). Moreover, TSAT ≤20% was significantly associated with left ventricular hypertrophy [odds ratio (OR) = 1.46], high-sensitivity C-reactive protein ≥3 mg/dL (OR = 2.09), N-terminal pro B-type natriuretic peptide ≥10000 pg/mL (OR = 2.04), and troponin-T≥0.1 ng/mL (OR = 2.02), on logistic regression analysis.<h4>Conclusions</h4>Low TSAT was a significant independent risk factor for adverse clinical outcome in incident dialysis patients with anemia, which may be partly attributed to cardiac dysfunction and inflammation.
format	article
author	Hyang Mo Koo Chan Ho Kim Fa Mee Doh Mi Jung Lee Eun Jin Kim Jae Hyun Han Ji Suk Han Hyung Jung Oh Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang
author_facet	Hyang Mo Koo Chan Ho Kim Fa Mee Doh Mi Jung Lee Eun Jin Kim Jae Hyun Han Ji Suk Han Hyung Jung Oh Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang
author_sort	Hyang Mo Koo
title	The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
title_short	The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
title_full	The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
title_fullStr	The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
title_full_unstemmed	The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
title_sort	relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/ae8938ddab6945369c2cb89482a1467c
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The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis.

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