{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T14:15:08Z","timestamp":1794492908210,"version":"4.9.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T00:00:00Z","timestamp":1571702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Keryx Biopharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anemia is associated with adverse outcomes in those with chronic kidney disease (CKD). We examined the association of absolute and functional iron deficiency anemia (IDA) with adverse outcomes (cardiovascular hospitalization, dialysis and mortality) in those with nondialysis-dependent CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nondialysis-dependent CKD patients followed in the US Veterans Administration with hemoglobin level measured within 90\u2009days of the date of the second estimated glomerular filtration rate &amp;lt;60\u2009mL\/min\/1.73\u2009m2 were included. Logistic regression, multivariate Cox proportional hazards and Poisson regression models adjusted for demographics and comorbidities were used to assess the prevalence and correlates of absolute [transferrin saturation (TSAT) \u226420%, ferritin &amp;lt;100\u00a0ng\/mL] and functional (TSA T\u226420%, ferritin &amp;gt;100\u2013500\u2009ng\/mL) IDA and the associations of absolute and functional IDA with mortality, dialysis and cardiovascular hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 933 463 patients with CKD, 20.6% had anemia. Among those with anemia, 23.6% of patients had both TSAT and ferritin level measured, of whom 30% had absolute IDA and 19% had functional IDA. Absolute IDA in CKD was not associated with an increased risk of mortality or dialysis but was associated with a higher risk of 1-year {risk ratio [RR] 1.20 [95% confidence interval (CI) 1.12\u20131.28]} and 2-year cardiovascular hospitalization [RR 1.11 (95% CI 1.05\u20131.17)]. CKD patients with functional IDA had a higher risk of mortality [hazard ratio (HR) 1.11 (95% CI 1.07\u20131.14)] along with a higher risk of 1-year [RR 1.21 (95% CI 1.1\u20131.30)] and 2-year cardiovascular hospitalization [RR 1.13 (95% CI 1.07\u20131.21)]. Ferritin &amp;gt;500\u2009ng\/mL (treated as a separate category) was only associated with an increased risk of mortality [HR 1.38 (95% CI 1.26\u20131.51)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a large population of CKD patients with anemia, absolute and functional IDA were associated with various clinical covariates. Functional IDA was associated with an increased risk of mortality and cardiovascular hospitalization, but absolute IDA was associated only with a higher risk of hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfz192","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T15:28:39Z","timestamp":1567178919000},"page":"129-136","source":"Crossref","is-referenced-by-count":83,"title":["Prevalence, correlates and outcomes of absolute and functional iron deficiency anemia in nondialysis-dependent chronic kidney disease"],"prefix":"10.1093","volume":"36","author":[{"given":"Ahmed A","family":"Awan","sequence":"first","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-2870","authenticated-orcid":false,"given":"Carl P","family":"Walther","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Richardson","sequence":"additional","affiliation":[{"name":"Center for Innovation in Quality Effectiveness & Safety, Michael E. Debakey VA Medican Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maulin","family":"Shah","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA"},{"name":"Center for Innovation in Quality Effectiveness & Safety, Michael E. Debakey VA Medican Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang C","family":"Winkelmayer","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sankar D","family":"Navaneethan","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA"},{"name":"Center for Innovation in Quality Effectiveness & Safety, Michael E. Debakey VA Medican Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"key":"2020122916295139400_gfz192-B1","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1681\/ASN.V132504","article-title":"Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey","volume":"13","author":"Hsu","year":"2002","journal-title":"J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B2","first-page":"S16","article-title":"Clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease in adults","volume":"47(Suppl 3)","year":"2006","journal-title":"Am J Kidney Dis"},{"key":"2020122916295139400_gfz192-B3","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.2215\/CJN.05541008","article-title":"Health-related quality of life in CKD patients: correlates and evolution over time","volume":"4","author":"Mujais","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B4","doi-asserted-by":"crossref","first-page":"2919","DOI":"10.1097\/01.ASN.0000092138.65211.71","article-title":"Association of high serum creatinine and anemia increases the risk of coronary events: results from the prospective community-based atherosclerosis risk in communities (ARIC) study","volume":"14","author":"Jurkovitz","year":"2003","journal-title":"J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B5","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1681\/ASN.2004070597","article-title":"Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease","volume":"16","author":"Weiner","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B6","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1038\/sj.ki.5000105","article-title":"Association of anemia with outcomes in men with moderate and severe chronic kidney disease","volume":"69","author":"Kovesdy","year":"2006","journal-title":"Kidney Int"},{"key":"2020122916295139400_gfz192-B7","doi-asserted-by":"crossref","first-page":"e84943","DOI":"10.1371\/journal.pone.0084943","article-title":"Prevalence of anemia in chronic kidney disease in the United States","volume":"9","author":"Stauffer","year":"2014","journal-title":"PLoS One"},{"issue":"4 Suppl 2","key":"2020122916295139400_gfz192-B8","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1053\/j.ajkd.2007.12.019","article-title":"Prevalence and associations of anemia of CKD: Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999\u20132004","volume":"51","author":"McFarlane","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"2020122916295139400_gfz192-B9","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1185\/030079904X2763","article-title":"The prevalence of anemia in patients with chronic kidney disease","volume":"20","author":"McClellan","year":"2004","journal-title":"Curr Med Res Opin"},{"key":"2020122916295139400_gfz192-B10","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1093\/ndt\/gft338","article-title":"Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics","volume":"28","author":"Minutolo","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"2020122916295139400_gfz192-B11","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"2020122916295139400_gfz192-B12","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0895-4356(92)90133-8","article-title":"Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases","volume":"45","author":"Deyo","year":"1992","journal-title":"J Clin Epidemiol"},{"key":"2020122916295139400_gfz192-B13","first-page":"288","article-title":"Kidney Disease: Improving Global Outcomes Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease","volume":"2","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"2020122916295139400_gfz192-B14"},{"key":"2020122916295139400_gfz192-B15","doi-asserted-by":"crossref","first-page":"e0193996","DOI":"10.1371\/journal.pone.0193996","article-title":"Leading causes of cardiovascular hospitalization in 8.45 million US veterans","volume":"13","author":"Krishnamurthi","year":"2018","journal-title":"PLoS One"},{"key":"2020122916295139400_gfz192-B16","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/nep.12493","article-title":"Anaemia management and mortality risk in newly visiting patients with chronic kidney disease in Japan: the CKD-ROUTE study","volume":"20","author":"Iimori","year":"2015","journal-title":"Nephrology (Carlton)"},{"key":"2020122916295139400_gfz192-B17","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1093\/ckj\/sfx060","article-title":"Quality of care and practice patterns in anaemia management at specialist kidney clinics in Ireland: a national study","volume":"11","author":"Stack","year":"2018","journal-title":"Clin Kidney J"},{"key":"2020122916295139400_gfz192-B18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1471-2369-14-24","article-title":"Association of anaemia in primary care patients with chronic kidney disease: cross sectional study of Quality Improvement in Chronic Kidney Disease (QICKD) trial data","volume":"14","author":"Dmitrieva","year":"2013","journal-title":"BMC Nephrol"},{"key":"2020122916295139400_gfz192-B19","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2215\/CJN.01670408","article-title":"Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988\u20132004","volume":"4","author":"Fishbane","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B20","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s12882-018-1021-3","article-title":"Association of different iron deficiency cutoffs with adverse outcomes in chronic kidney disease","volume":"19","author":"Eisenga","year":"2018","journal-title":"BMC Nephrol"},{"key":"2020122916295139400_gfz192-B21","doi-asserted-by":"crossref","first-page":"435","DOI":"10.2215\/CJN.03980808","article-title":"Association of markers of iron stores with outcomes in patients with nondialysis-dependent chronic kidney disease","volume":"4","author":"Kovesdy","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B22","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/ki.1984.36","article-title":"Erythropoietin deficiency and inhibition of erythropoiesis in renal insufficiency","volume":"25","author":"McGonigle","year":"1984","journal-title":"Kidney Int"},{"key":"2020122916295139400_gfz192-B23","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1097\/01.ASN.0000016440.52271.F7","article-title":"Anemia management in chronic kidney disease: role of factors affecting epoetin responsiveness","volume":"13","author":"Eschbach","year":"2002","journal-title":"J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B24","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1053\/j.ajkd.2011.03.031","article-title":"Red blood cell survival in long-term dialysis patients","volume":"58","author":"Vos","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"2020122916295139400_gfz192-B25","doi-asserted-by":"crossref","first-page":"7806","DOI":"10.1074\/jbc.M008922200","article-title":"Hepcidin, a urinary antimicrobial peptide synthesized in the liver","volume":"276","author":"Park","year":"2001","journal-title":"J Biol Chem"},{"key":"2020122916295139400_gfz192-B26","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.2215\/CJN.05931108","article-title":"Hepcidin\u2014a potential novel biomarker for iron status in chronic kidney disease","volume":"4","author":"Zaritsky","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B27","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.semnephrol.2016.05.002","article-title":"Disorders of iron metabolism and anemia in chronic kidney disease","volume":"36","author":"Panwar","year":"2016","journal-title":"Semin Nephrol"},{"key":"2020122916295139400_gfz192-B28","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1681\/ASN.2006070802","article-title":"Molecular control of iron transport","volume":"18","author":"Ganz","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B29","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1093\/ndt\/gfp758","article-title":"Initiation of anaemia management in patients with chronic kidney disease not on dialysis in the Veterans Health Administration","volume":"25","author":"Lawler","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"2020122916295139400_gfz192-B30","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.2215\/CJN.01390406","article-title":"The fascinating but deceptive ferritin: to measure it or not to measure it in chronic kidney disease?","volume":"1(Suppl 1)","author":"Kalantar-Zadeh","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B31","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2215\/CJN.04280609","article-title":"Can the response to iron therapy be predicted in anemic nondialysis patients with chronic kidney disease?","volume":"5","author":"Stancu","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020122916295139400_gfz192-B32","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1136\/jcp.2009.064451","article-title":"Improved method for assessing iron stores in the bone marrow","volume":"62","author":"Phiri","year":"2009","journal-title":"J Clin Pathol"},{"key":"2020122916295139400_gfz192-B33","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s002770000261","article-title":"A bone marrow report of absent stainable iron is not diagnostic of iron deficiency","volume":"80","author":"Barron","year":"2001","journal-title":"Ann Hematol"},{"key":"2020122916295139400_gfz192-B34","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1053\/j.ajkd.2009.10.043","article-title":"Bone marrow iron, iron indices, and the response to intravenous iron in patients with non-dialysis-dependent CKD","volume":"55","author":"Stancu","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2020122916295139400_gfz192-B35","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12882-018-0861-1","article-title":"Prevalence, treatment patterns, and healthcare resource utilization in Medicare and commercially insured non-dialysis-dependent chronic kidney disease patients with and without anemia in the United States","volume":"19","author":"St Peter","year":"2018","journal-title":"BMC Nephrol"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ndt\/article-pdf\/36\/1\/129\/35253678\/gfz192.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ndt\/article-pdf\/36\/1\/129\/35253678\/gfz192.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T20:50:23Z","timestamp":1664225423000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/36\/1\/129\/5602623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,22]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,10,22]]},"published-print":{"date-parts":[[2021,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfz192","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,1]]},"published":{"date-parts":[[2019,10,22]]}}}