Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan.
Blood Purif. 2019;48(2):158-166. doi: 10.1159/000499758. Epub 2019 Jul 16.
Transferrin saturation (TSAT) is an index that represents the iron-binding capacity of transferrin, which is the main transport protein for iron, and is widely used to evaluate iron status.
To evaluate the prognostic importance of TSAT in Japanese patients on maintenance hemodialysis (MHD).
A total of 398 patients on MHD were recruited and divided into 3 groups on the basis of their baseline TSAT levels (<20, 20-40, and >40%).
There was no difference in the proportion of patients on erythropoiesis-stimulating agents or iron supplements between the 3 groups. During a mean follow-up period of 52.2 ± 1 6.3 months, 130 patients died of cardiovascular causes (n = 63, 15.8%) or infection (n = 47, 11.8%). Compared with the reference group (TSAT 20-40%), patients with a TSAT <20% had a significantly higher all-cause mortality rate (6.44 vs. 9.55 events per 100 patient-years, p = 0.0452). Kaplan-Meier analysis showed that all-cause mortality rate was significantly higher in patients with TSAT <20% than in the other 2 groups (p = 0.0353).
Low TSAT was a significant independent risk factor for all-cause mortality in a cohort of Japanese patients on MHD. The findings of this study suggest that the adverse clinical outcomes in patients with low TSAT can be partly attributed to infection-related iron deficiency.
转铁蛋白饱和度（TSAT）是代表转铁蛋白铁结合能力的指标，转铁蛋白是铁的主要转运蛋白，广泛用于评估铁状态。
评估 TSAT 在日本维持性血液透析（MHD）患者中的预后重要性。
共招募了 398 名 MHD 患者，并根据基线 TSAT 水平（<20、20-40 和>40%）将其分为 3 组。
3 组患者中使用促红细胞生成素和铁补充剂的比例没有差异。在平均 52.2±16.3 个月的随访期间，130 名患者死于心血管原因（n=63，15.8%）或感染（n=47，11.8%）。与参考组（TSAT 20-40%）相比，TSAT<20%的患者全因死亡率显著更高（6.44 与 9.55 例/100 患者年，p=0.0452）。Kaplan-Meier 分析显示，TSAT<20%的患者全因死亡率明显高于其他 2 组（p=0.0353）。
低 TSAT 是日本 MHD 患者全因死亡率的独立显著危险因素。本研究结果表明，低 TSAT 患者的不良临床结局部分归因于与感染相关的缺铁。
