Dmed Samsun Dialysis Clinic, Samsun, Turkey.
Department of Nephrology, Ordu University Faculty of Medicine, Ordu, Turkey.
Blood Purif. 2022;51(1):55-61. doi: 10.1159/000515639. Epub 2021 Apr 7.
The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study.
A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin <800 ng/mL, group 2: serum ferritin 800-1,500 ng/mL, and group 3: serum ferritin >1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis.
Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5-60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, p = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05-0.49]; p = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12-0.88]; p = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23-1.04]; p = 0.063).
Time-averaged serum ferritin levels >1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.
高血清铁蛋白水平对血液透析患者的长期死亡率的影响尚不清楚。本研究旨在探讨血清铁蛋白水平与血液透析患者 5 年全因死亡率之间的关系。
本研究共纳入 173 例维持性血液透析患者。患者随访时间最长达 5 年，并根据时间平均血清铁蛋白水平分为 3 组（组 1：血清铁蛋白<800ng/ml；组 2：血清铁蛋白 800-1500ng/ml；组 3：血清铁蛋白>1500ng/ml）。除了血清铁蛋白水平外，还将可能影响死亡率的其他临床和实验室变量纳入 Cox 比例风险回归分析。
在 5 年的随访期间，81 例（47%）患者死亡。中位随访时间为 38（17.5-60）个月。组 1、组 2 和组 3 的 5 年生存率分别为 44%、64%和 27%。组 3 的生存率低于组 1 和组 2（对数秩检验，p=0.002）。在组 1 中，死亡率明显低于组 3（HR[95%CI]：0.16[0.05-0.49]；p=0.001）。在组 2 中，死亡率也低于组 3（HR[95%CI]：0.32[0.12-0.88]；p=0.026）。组 1 和组 2 之间的死亡率无显著差异（HR[95%CI]：0.49[0.23-1.04]；p=0.063）。
血液透析患者的时间平均血清铁蛋白水平>1500ng/ml 与 5 年全因死亡率增加相关。
