Mehta R, Cho ME, Cai X, et al. - It was shown that functional iron deficiency was not significantly correlated with any outcome, and no iron group significantly correlated with atherosclerotic cardiovascular disease. Fibroblast growth factor 23 (FGF23) most significantly mediated the risks of mortality and heart failure conferred by Iron Deficiency among the candidate facilitators. Therefore, in patients with chronic kidney disease, alterations in iron homeostasis are correlated with adverse cardiovascular and kidney outcomes.

• Researchers evaluated the risks of mortality, heart failure, end-stage kidney disease (ESKD), and atherosclerotic cardiovascular disease according to iron status, and tested for mediation by C-terminal FGF23, hemoglobin, and parathyroid hormone in a prospective analysis of 3,747 participants in the Chronic Renal Insufficiency Cohort Study.

• Individuals were classified based on quartiles of transferrin saturation and ferritin as: “Iron Replete” (27.1% of participants; referent group for all outcomes analyses), “Iron Deficiency” (11.1%), “Functional Iron Deficiency” (7.6%), “Mixed Iron Deficiency” (iron indices between the Iron Deficiency and Functional Iron Deficiency groups; 6.3%), “High Iron” (9.2%), or “Non-Classified” (the remaining 38.8% of participants). Iron Deficiency is independently associated with mortality (hazard ratio 1.28, 95% confidence interval 1.04–1.58) and heart failure (1.34, 1.05– 1.72) in multivariable-adjusted Cox models.

• It has been reported that mixed Iron Deficiency is correlated with mortality (1.61, 1.27–2.04) and ESKD (1.33, 1.02–1.73).

• According to the findings, high Iron correlated with mortality (1.54, 1.24–1.91), heart failure (1.58, 1.21–2.05), and ESKD (1.41, 1.13–1.77).