The Relationship of Iron Stores Biomarkers with Chronic Heart Failure in Nondialysis Chronic Kidney Disease Patients

Background: Patients with chronic heart failure (CHF) benefit from treatment for iron deficiency by having better cardiac and renal function.

Objective: To evaluate the relationship of serum biomarkers of iron stores with CHF in nondialysis chronic kidney disease (CKD) patients, with or without anemia and to evaluate the therapeutic effect of iron sucrose administration for HF patients with iron deficiency.

Patients and Methods: This prospective study was conducted on 143 patients with CHF with eGFR < 60 ml/min/1.73 m2 for evaluation the association of TSAT and serum ferretin level categories with all clinical, biochemical characteristics, NYHA functional class and echocardiographic findings. Only 100 patients were selected and randomized into two groups (control group and iron sucrose group) and followed up by echocardiography for 3 months.

Results: There were statistically significant differences in clinical, biochemical and echocardiographic parameters between iron stores level categories with better outcomes in higher TSAT and s. ferretin level categories. Intravenous iron was associated with improved renal function (both p<0.01 versus control). left ventricular systolic and diastolic diameters were decreased (p<0.01), global longitudinal systolic strain was significantly decreased (p<0.01) indicating improved left ventricular function.

Conclusion: Higher s. ferretin and TSAT level categories was associated with better outcomes involving clinical, biochemical and echocardiographic findings in comparison with lower s. ferretin and TSAT level categories in patients with heart failure and non-dialysis CKD. In patients with HF, intravenous iron therapy was linked to better myocardial functional measures and cardiac dimensions.