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  • Optimal TSAT levels...

Optimal TSAT levels lower CV events in CKD patients under long-acting erythropoiesis-stimulating agents, finds study

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-07-12T07:00:02+05:30  |  Updated On 12 July 2024 7:00 AM IST
Optimal TSAT levels lower CV events in CKD patients under  long-acting erythropoiesis-stimulating agents, finds study
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A recent study provided new insights into the relationship between iron deficiency and cardiovascular events in patients with chronic kidney disease (CKD) who were receiving long-acting erythropoiesis-stimulating agents (ESAs). The findings published in the Journal of Nephrology suggest that maintaining higher levels of transferrin saturation (TSAT) may improve the cardiovascular outcomes for these population.

Long-acting ESAs like darbepoetin alfa have become common treatment for anemia in CKD patients. Despite the improvements in anemia management, the overall prognosis for these patients has not significantly improved. Iron deficiency is linked to the development of cardiovascular diseases (CVDs) and may be a contributing factor. ESAs can induce a state of relative iron deficiency which is potentially limiting the expected improvements on the patient prognosis. This study analyzed the association between iron deficiency and cardiovascular events in CKD patients who were treated with darbepoetin alfa with TSAT as a marker. TSAT is considered less susceptible to inflammation than ferritin which makes it a more reliable indicator of iron status.

The study included a total of 1,040 non-dialysis-dependent CKD patients who were at least 20 years old with a glomerular filtration rate of less than 60 mL/min/1.73 m² and hemoglobin levels below 11 g/dL. These patients were part of the BRIGHTEN Trial which evaluated ESA resistance in treating anemia in non-dialysis-dependent CKD. The analysis revealed that patients with TSAT levels of 30% or higher had a significantly better prognosis for cardiovascular events. Also, the adjusted hazard ratio for these patients was 0.34 (95% CI: 0.22–0.52) which suggests that higher TSAT levels were associated with a substantially lower risk of cardiovascular events.

Further stratified analysis showed that patients with TSAT levels between 30% and 40% had a significantly lower risk of cardiovascular events when compared to the patients with TSAT levels between 20% and 30%. The multivariate-adjusted hazard ratio for this group was 0.33 (95% CI: 0.21–0.54). These findings suggest that maintaining TSAT levels between 30% and 40% could lead to significantly fewer cardiovascular events in CKD patients treated with long-acting ESAs. This brings out the potential importance of closely monitoring and managing iron levels to improve cardiovascular outcomes in this patient population.

This study prompts to consider strategies to maintain higher TSAT levels in CKD patients who were undergoing ESA therapy. This could improve the responsiveness to treatment and reduce the risk of cardiovascular events by improving patient prognosis. Further research is needed to develop more targeted interventions to optimize iron levels and improve clinical outcomes for these patients.

Reference:

Nakai, K., Nishino, T., Kagimura, T., & Narita, I. (2024). Impact of transferrin saturation on cardiovascular events in non-dialysis-dependent chronic kidney disease patients treated with darbepoetin alfa. In Journal of Nephrology. Springer Science and Business Media LLC. https://doi.org/10.1007/s40620-024-02000-y

Journal of NephrologyChronic kidney diseaseCardiovascular events
Source : Journal of Nephrology
Jacinthlyn Sylvia
Jacinthlyn Sylvia

    Neuroscience Masters graduate

    Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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