Serum Ferritin Predicts Mortality Regardless of Inflammatory and Nutritional Status in Patients Starting Dialysis: A Prospective Cohort Study.
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).


CONCLUSIONS
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.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kyoung Sook
KS
Park
Geun Woo
GW
Ryu
Jong Hyun
JH
Jhee
Hyung Woo
HW
Kim
Seohyun
S
Park
Sul A
SA
Lee
Young Eun
YE
Kwon
Yung Ly
YL
Kim
Han Jak
HJ
Ryu
Mi Jung
MJ
Lee
Seung Hyeok
SH
Han
Tae-Hyun
TH
Yoo
Yong-Lim
YL
Kim
Yon Su
YS
Kim
Chul Woo
CW
Yang
Nam-Ho
NH
Kim
Shin-Wook
SW
Kang
Jung Tak
JT
Park
D000368:Aged; D001424:Bacterial Infections / Q000097:blood* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors
D015415:Biomarkers; D005293:Ferritins