血清铁蛋白可预测开始透析患者的死亡率，与炎症和营养状况无关：一项前瞻性队列研究。

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

作者信息

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

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Blood Purif. 2015;40(3):209-17. doi: 10.1159/000438819. Epub 2015 Sep 1.

DOI:10.1159/000438819

PMID:26329834

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.

摘要

背景

血清铁蛋白对开始血液透析（HD）患者预后的影响尚未完全阐明。

方法

本研究选取了来自韩国26个透析中心的946例新发HD患者的前瞻性队列。根据自然对数（Ln）铁蛋白浓度将患者分为三分位数。

结果

在中位随访39个月期间，88例（9.3%）患者死亡。多变量Cox比例风险分析表明，Ln铁蛋白与心血管死亡风险增加（风险比（HR）1.604，95%置信区间1.040 - 2.474，p = 0.033）、感染相关死亡风险（HR 1.916，95%置信区间1.056 - 3.476，p = 0.032）和全因死亡风险（HR 1.547，95%置信区间1.156 - 2.069，p = 0.003）独立相关。