Serum ferritin predicts mortality regardless of inflammatory and nutritional status in patients starting dialysis: A prospective cohort study

Kyoung Sook Park, Geun Woo Ryu, Jong Hyun Jhee, Hyung Woo Kim, Seohyun Park, Sul A. Lee, Young Eun Kwon, Yung Ly Kim, Han Jak Ryu, Mi Jung Lee, Seung Hyeok Han, Tae Hyun Yoo, Yong Lim Kim, Yon Su Kim, Chul Woo Yang, Nam Ho Kim, Shin Wook Kang, Jung Tak Park

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Abstract

Background: The impact of serum ferritin on prognosis in patients starting hemodialysis (HD) is not fully elucidated. Methods: A prospective cohort of 946 incident HD patients from 26 dialysis centers in Korea was selected for this study. Patients were divided into tertiles according to natural logarithm (Ln) ferritin concentrations. Results: During a median follow-up of 39 months, 88 (9.3%) patients died. Multivariate Cox proportional hazard analysis demonstrated that Ln ferritin was independently associated with an increase in cardiovascular mortality risk (hazard ratio (HR) 1.604, 95% CI 1.040-2.474, p = 0.033), infection-related mortality risk (HR 1.916, 95% CI 1.056-3.476, p = 0.032), and all-cause mortality risk (HR 1.547, 95% CI 1.156-2.069, p = 0.003). Conclusion: Serum ferritin levels at the time of HD commencement were a significant independent risk factor for mortality regardless of systemic inflammation and nutritional status. Therefore, elevated serum ferritin levels could be an effective indicator for prognosis.

Original languageEnglish
Pages (from-to)209-217
Number of pages9
JournalBlood Purification
Volume40
Issue number3
DOIs
Publication statusPublished - 2015 Oct 1

All Science Journal Classification (ASJC) codes

  • Hematology
  • Nephrology

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    Park, K. S., Ryu, G. W., Jhee, J. H., Kim, H. W., Park, S., Lee, S. A., Kwon, Y. E., Kim, Y. L., Ryu, H. J., Lee, M. J., Han, S. H., Yoo, T. H., Kim, Y. L., Kim, Y. S., Yang, C. W., Kim, N. H., Kang, S. W., & Park, J. T. (2015). Serum ferritin predicts mortality regardless of inflammatory and nutritional status in patients starting dialysis: A prospective cohort study. Blood Purification, 40(3), 209-217. https://doi.org/10.1159/000438819