title: The Different Association between Serum Ferritin and Mortality in Hemodialysis and Peritoneal Dialysis Patients Using Japanese Nationwide Dialysis Registry.
abstract: OBJECTIVE
  Monitoring of serum ferritin levels is widely recommended in the management of anemia among patients on dialysis. However, associations between serum ferritin and mortality are unclear and there have been no investigations among patients undergoing peritoneal dialysis (PD).
  
  
  METHODS
  Baseline data of 191,902 patients on dialysis (age, 65 ± 13 years; male, 61.1%; median dialysis duration, 62 months) were extracted from a nationwide dialysis registry in Japan at the end of 2007. Outcomes, such as one-year mortality, were then evaluated using the registry at the end of 2008.
  
  
  RESULTS
  Within one year, a total of 15,284 (8.0%) patients had died, including 6,210 (3.2%) cardiovascular and 2,707 (1.4%) infection-related causes. Higher baseline serum ferritin levels were associated with higher mortality rates among patients undergoing hemodialysis (HD). In contrast, there were no clear associations between serum ferritin levels and mortality among PD patients. Multivariate Cox regression analysis of HD patients showed that those in the highest serum ferritin decile group had higher rates of all-cause and cardiovascular mortality than those in the lowest decile group (hazard ratio [HR], 1.54; 95% confidence interval [CI], 1.31-1.81 and HR, 1.44; 95% CI, 1.13-1.84, respectively), whereas associations with infection-related mortality became non-significant (HR, 1.14; 95% CI, 0.79-1.65).
  
  
  CONCLUSIONS
  Using Japanese nationwide dialysis registry, higher serum ferritin values were associated with mortality not in PD patients but in HD patients.
authors.affiliation: Division of Nephrology and Hypertension, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Maruyama
authors.affiliation: Division of Nephrology and Hypertension, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: Division of Nephrology and Hypertension, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoo
authors.affiliation: Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shigematsu
authors.affiliation: Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Tsubakihara
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000097:blood / Q000628:therapy; D005260:Female; D005293:Ferritins / Q000097:blood*; D005921:Glomerulonephritis / Q000097:blood / Q000628:therapy; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009400:Nephrosclerosis / Q000097:blood / Q000628:therapy; D010530:Peritoneal Dialysis / Q000401:mortality*; D007690:Polycystic Kidney Diseases / Q000097:blood / Q000628:therapy; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000379:methods* / Q000401:mortality*; D014168:Transferrin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D014168:Transferrin; D005293:Ferritins