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 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 (> or =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.


CONCLUSIONS
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.
Hasuike
Yukiko
Y
Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. cherry39@hyo-med.ac.jp
Nonoguchi
Hiroshi
H
Tokuyama
Masanori
M
Ohue
Mai
M
Nagai
Takanori
T
Yahiro
Mana
M
Nanami
Masayoshi
M
Otaki
Yoshinaga
Y
Nakanishi
Takeshi
T
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
D015415:Biomarkers; D005293:Ferritins
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