MO526: Renal Function in Patients With Non-Dialysis Kidney Disease Treated With Ferric Carboxymaltose

Abstract

Abstract BACKGROUND AND AIMS Iron deficiency anemia occurs in most patients with non-dialysis chronic kidney disease (ND-CKD). Several studies have suggested the efficacy and safety of ferric carboxymaltose (FCM) in this group of patients, but none have shown a positive impact on renal function. The aim our study was to investigate the impact of FCM on renal function in ND-CKD patients. METHOD Prospective observational study of ND-CKD stages 3 to 5 patients, with anemia and iron deficiency [ferritin level <100 µg/L or <200 µg/L with transferrin saturation (TSAT) <20%], treated with FCM from 01 January 2019 to 31 June 2021. FCM was administrated as a single IV infusion. Patients were categorized into two cohorts according to the dose of FCM received: 500 mg or 1000 mg. Clinical and analytical data were compared among groups at baseline and 24 weeks after infusion. Renal function was assessed using estimated glomerular filtration rate (eGFR), calculated using the CKD-EPI formula. Statistical analysis was executed using SPSS (Version 23 for Mac OSX). RESULTS The mean age of 140 patients was 77.31 ± 9.68 years, 62 (44.3%) were male, 86 (61.4%) were diabetic, 84 (60%) had congestive heart failure and 121 (86.4%) had hypertension. Thirty-five (25%) patients had CKD stage 3, 74 (52.9%) had stage 4 and 31 (22.1%) had stage 5. Seventy-eight (55.7%) patients were treated with 1000 mg of FCM. There were no gender, comorbidity, CKD etiology or stage differences among groups. Patients treated with 1000 mg were younger (74.36 ± 13.59 versus 78.44 ± 9.28 years, P = .046). At baseline, mean Hb was 10.4 ± 1.35, 10.27 ± 1.47 and 10.54 ± 1.2 g/dL and mean eGFR was 26.18 ± 17.167, 23.55 ± 4.17 and 28.71 ± 19.43 mL/min/1.73 m2 for the whole group, 1000 mg and 500 mg cohorts. At 24 weeks, Hb showed an increase of 1.24 ± 1.78 (P = .001), 1.54 ± 1.99 (P = .001) and 0.86 ± 1.4 g/dL (P = .001), and eGFR an increase of 1.13 ± 6.49 (P = .041) and 1.55 ± 6.87 mL/min/1.73 m2 (P = .049) for the whole group and 1000 mg cohort, but not 500 mg cohort. A Pearson correlation was performed and revealed a positive correlation between the variation of Hb and eGFR during the study follow-up period (r = .283, P = .001 and r = .310, P = .008) in the same groups. CONCLUSION In addition to the effectiveness in correcting iron deficiency anemia in patients with ND-CKD, our results suggest a positive impact on renal function of higher doses of FCM after 6 months of administration.