Cardiometabolic & kidneySecondary analysis
Iron deficiency and risk of cardiovascular events in chronic kidney disease (CKD): insights from the ASCEND-ND trial
- Post-hoc analysis of the ASCEND-ND randomised trial
- time-updated multivariable Cox regression
Authors' 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
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) | |
|---|---|---|
| HFH | 1.97 (1.40–2.79) | |
| CV death | 2.19 (1.45–3.29) | |
| All-cause mortality | 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:10.1093/ejhf/xuag171
Summarised from the published abstract; every number is checked against it