Serum biomarkers of iron stores are associated with worse physical health-related quality of life (HRQoL) in non-dialysis dependent chronic kidney disease (NDD-CKD) patients with or without anemia.

Background Iron deficiency (ID) is a common condition in non-dialysis dependent chronic kidney disease (NDD-CKD) patients that is associated with poorer clinical outcomes. However, the effect of ID on health-related quality of life (HRQoL) in this population is unknown. We analyzed data from a multinational cohort of NDD-CKD stage 3 to 5 patients to test the association between transferrin saturation index (TSAT) and ferritin with HRQoL. Methods Patients from Brazil (N = 205), France (N = 2015), and the US (N = 293) in the CKD Outcomes and Practice Patterns Study (CKDopps, 2013 to 2019) were included. We evaluated the association of TSAT and ferritin (and functional and absolute ID, defined as TSAT ≤ 20% and ferritin >300 or Results TSAT ≤15% and both ferritin Conclusions Low TSAT levels, as well as both low TSAT with lower ferritin and low TSAT with high ferritin, are associated with worse physical HRQoL in NDD-CKD patients, even after accounting for Hgb level. Interventional studies of iron therapy on HRQoL among NDD-CKD individuals are needed to confirm these findings.