Frontiers in Medicine (Jan 2020)

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

  • Yongjian Zhu,
  • Xiaozhuan Liu,
  • Ning Li,
  • Lingling Cui,
  • Xiaofeng Zhang,
  • Xinxin Liu,
  • Kailun Yu,
  • Yao Chen,
  • Zhongxiao Wan,
  • Zengli Yu

DOI
https://doi.org/10.3389/fmed.2019.00303
Journal volume & issue
Vol. 6

Abstract

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Background: Even though it is well-known that iron deficiency is the result of chronic kidney disease (CKD), whether iron will affect kidney function and disease in the general population is not clear. We thus conducted a nationwide cross-sectional study using data from the China Health and Nutrition Survey (CHNS) to assess the relationship of iron status with estimated glomerular filtration rate (eGFR) and CKD among general adults.Methods: A total of 8,339 adults from the China Health and Nutrition Survey in the wave of 2009 were included to assess the association between iron status and eGFR/CKD. Serum ferritin (SF), transferrin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) were measured. The relationship of iron status and eGFR was evaluated by using multi-variable linear regression model. The effect of iron status on the odds of CKD was calculated by logistic regression model.Results: For the association between iron status and eGFR, every 100 μg/L increase in SF was correlated with 0.26 ml/min per 1.73 m2 (95% CI: 0.08–0.44) decrease in eGFR, and every 5 mg/L increase in sTfR was associated with a decrease of 6.00 ml/min per 1.73 m2 (95% CI: 3.79–8.21) in eGFR. There were no significant associations between Hb or transferrin with eGFR. For the association between iron status and CKD, every 5 g/L increase in sTfR was associated with an odds ratio of 3.72 (95% CI: 2.16–6.13) for CKD. The concentrations of Hb were associated with the odds of CKD in a U-shaped manner, with the lowest risk in the Hb range of 136–141 g/L. There was a positive correlation between SF concentration and CKD prevalence but not in a dose–response manner. The odds of CKD for participants in the highest tertile increased by 28% (98% CI: 1–63%) compared with those in the lowest tertile.Conclusion: The concentration of SF and sTfR was positively correlated with the odds of CKD, and Hb was associated with the odds of CKD in a U-shaped manner. Further large prospective researches are warranted to confirm these findings.

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