Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations

Abstract Low transferrin saturation (TSAT), calculated by serum iron divided by total iron-binding capacity (TIBC), indicates iron deficiency. Because malnutrition and inflammation are associated with low TIBC in chronic kidney disease (CKD), TSAT might not reflect iron status or risk for anemia. We...

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Autores principales:	Pei-Hua Yu, Ming-Yen Lin, Yi-Wen Chiu, Jia-Jung Lee, Shang-Jyh Hwang, Chi-Chih Hung, Hung-Chun Chen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e5f91c5cfda44b0f805e58c53d234fb6
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spelling	oai:doaj.org-article:e5f91c5cfda44b0f805e58c53d234fb62021-12-02T15:51:13ZLow serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations10.1038/s41598-021-87401-w2045-2322https://doaj.org/article/e5f91c5cfda44b0f805e58c53d234fb62021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87401-whttps://doaj.org/toc/2045-2322Abstract Low transferrin saturation (TSAT), calculated by serum iron divided by total iron-binding capacity (TIBC), indicates iron deficiency. Because malnutrition and inflammation are associated with low TIBC in chronic kidney disease (CKD), TSAT might not reflect iron status or risk for anemia. We examined whether low serum iron was a risk factor for anemia in CKD patients with normal TSAT. Thus we compare the risk for anemia in 2500 CKD stage 1–4 patients divided by TSAT (cutoff: 20%) and serum iron (cutoff: 70 μg/dL in men, 60 μg/dL in women). Our results confirmed low TIBC (< 200 μg/dL) was associated with hypoalbuminemia and high C-reactive protein. In fully-adjusted logistic regression, both “normal TSAT low iron” and “low TSAT low iron” groups were associated with baseline anemia (hemoglobin < 11 g/dL) (odds ratios (OR) 1.56; 95% confidence interval (CI) 1.13–2.16 and OR 2.36; 95% CI 1.76–3.18, respectively) compared with the reference group (normal TSAT normal iron). Sensitivity tests with different cutoffs for TSAT and iron also showed similar results. In patients without anemia, both groups were associated with anemia after 1 year (OR 1.69; 95% CI 1.00–2.83 and OR 1.94; 95% CI 1.11–3.40, respectively). In conclusion, CKD stage 1–4 patients with normal TSAT but low serum iron are still at risk for anemia.Pei-Hua YuMing-Yen LinYi-Wen ChiuJia-Jung LeeShang-Jyh HwangChi-Chih HungHung-Chun ChenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Pei-Hua Yu Ming-Yen Lin Yi-Wen Chiu Jia-Jung Lee Shang-Jyh Hwang Chi-Chih Hung Hung-Chun Chen Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
description	Abstract Low transferrin saturation (TSAT), calculated by serum iron divided by total iron-binding capacity (TIBC), indicates iron deficiency. Because malnutrition and inflammation are associated with low TIBC in chronic kidney disease (CKD), TSAT might not reflect iron status or risk for anemia. We examined whether low serum iron was a risk factor for anemia in CKD patients with normal TSAT. Thus we compare the risk for anemia in 2500 CKD stage 1–4 patients divided by TSAT (cutoff: 20%) and serum iron (cutoff: 70 μg/dL in men, 60 μg/dL in women). Our results confirmed low TIBC (< 200 μg/dL) was associated with hypoalbuminemia and high C-reactive protein. In fully-adjusted logistic regression, both “normal TSAT low iron” and “low TSAT low iron” groups were associated with baseline anemia (hemoglobin < 11 g/dL) (odds ratios (OR) 1.56; 95% confidence interval (CI) 1.13–2.16 and OR 2.36; 95% CI 1.76–3.18, respectively) compared with the reference group (normal TSAT normal iron). Sensitivity tests with different cutoffs for TSAT and iron also showed similar results. In patients without anemia, both groups were associated with anemia after 1 year (OR 1.69; 95% CI 1.00–2.83 and OR 1.94; 95% CI 1.11–3.40, respectively). In conclusion, CKD stage 1–4 patients with normal TSAT but low serum iron are still at risk for anemia.
format	article
author	Pei-Hua Yu Ming-Yen Lin Yi-Wen Chiu Jia-Jung Lee Shang-Jyh Hwang Chi-Chih Hung Hung-Chun Chen
author_facet	Pei-Hua Yu Ming-Yen Lin Yi-Wen Chiu Jia-Jung Lee Shang-Jyh Hwang Chi-Chih Hung Hung-Chun Chen
author_sort	Pei-Hua Yu
title	Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
title_short	Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
title_full	Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
title_fullStr	Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
title_full_unstemmed	Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations
title_sort	low serum iron is associated with anemia in ckd stage 1–4 patients with normal transferrin saturations
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e5f91c5cfda44b0f805e58c53d234fb6
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Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations

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