Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study

Background The mortality in end-stage renal disease patients with dialysis remains high. Serum ferritin is a useful surrogated marker of iron storage. It has not been elucidated whether the ferritin level can predict the prognosis of patients with dialysis but without obvious inflammation. To clarif...

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Published in:Clinical and experimental nephrology 2010-08, Vol.14 (4), p.349-355
Main Authors: Hasuike, Yukiko, Nonoguchi, Hiroshi, Tokuyama, Masanori, Ohue, Mai, Nagai, Takanori, Yahiro, Mana, Nanami, Masayoshi, Otaki, Yoshinaga, Nakanishi, Takeshi
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - blood
Female
Ferritins - blood
Humans
Japan
Kaplan-Meier Estimate
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Original Article
Proportional Hazards Models
Prospective Studies
Renal Dialysis - mortality
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Up-Regulation
Urology
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Summary:Background The mortality in end-stage renal disease patients with dialysis remains high. Serum ferritin is a useful surrogated marker of iron storage. It has not been elucidated whether the ferritin level can predict the prognosis of patients with dialysis but without obvious inflammation. To clarify whether the ferritin level is involved in the prognosis in dialyzed patients, we investigated the relation between ferritin level and mortality in hemodialyzed patients during long-term follow-up. Methods Ninety stable hemodialyzed patients were enrolled and followed for 107 months. Serum ferritin and related factors (dialysis, nutrition, iron metabolism, inflammation and oxidative stress) were measured and used for statistical analysis. Survival analysis of death for ferritin as a predictive variable was performed. Results A relatively high level of serum ferritin (≥100 ng/ml) was associated with poor prognosis after adjustment for basic factors and C reactive protein (hazard ratio, 4.18). Hemoglobin-stratified Kaplan-Meier analysis showed that the prognosis for the high ferritin-low hemoglobin group was significantly poor. Conclusion This study suggests that the ferritin level is closely associated with high mortality in hemodialyzed patients. Further studies investigating the pathological role of iron storage on survival of hemodialyzed patients with large populations are needed.
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-010-0288-x