High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study.
OBJECTIVE
The aim of the study was to clarify the relationship between serum ferritin and infectious risks.


METHODS
We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months.


RESULTS
Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition.


CONCLUSIONS
Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.
Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden.
Sawako
S
Kato
Bengt
B
Lindholm
Yukio
Y
Yuzawa
Yoshinari
Y
Tsuruta
Kana
K
Nakauchi
Kaoru
K
Yasuda
Sachiyo
S
Sugiura
Kunio
K
Morozumi
Naotake
N
Tsuboi
Shoichi
S
Maruyama
D000368:Aged; D015331:Cohort Studies; D005293:Ferritins / Q000009:adverse effects / Q000097:blood*; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007239:Infections / Q000209:etiology*; D007564:Japan; D053208:Kaplan-Meier Estimate; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors
D005293:Ferritins