Iron deficiency and risk of cardiovascular events in chronic kidney disease (CKD): insights from the ASCEND-ND trial
Primary result · HFH or CV deathResult — go to the resultHazard ratio 2.13 95% CI 1.62–2.80Authors' conclusion
Iron deficiency defined by low transferrin saturation, but not low ferritin levels, is associated with increased risk of heart failure and cardiovascular death in CKD, independent of hemoglobin.
Study context
- Population
- Non-dialysis CKD patients with anaemia (ASCEND-ND trial); median age 67 years, 56% women, median eGFR 18 mL/min/1.73m2
- Participants
- 3,872 patients
- Comparison
- Low transferrin saturation (TSAT) or ferritin vs reference iron levels
- Primary endpoint
- HF hospitalization (heart failure hospitalization (HFH)) or CV death
Methodological detailstime-updated multivariable Cox regression
- Time-updated multivariable Cox regression
Primary result
HFH or CV death
Hazard ratio
2.13
95% CI 1.62–2.80
TSAT ≤20%vs TSAT >30-≤40%
HR 2.13 (95% CI 1.62–2.80)
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| HFHTSAT ≤20%vs TSAT >30-≤40% | 1.97 (1.40–2.79) | |
| CV deathTSAT ≤20%vs TSAT >30-≤40% | 2.19 (1.45–3.29) | |
| All-cause mortalityTSAT ≤20%vs TSAT >30-≤40% | 1.60 (1.25–2.03) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Iron deficiency and risk of cardiovascular events in CKD: insights from the ASCEND-ND trial. Eur J Heart Fail. Published 15 May 2026. doi:10.
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