Yin Qinghua, Guo Na, Fu Ping, Zhong Hui
Kidney Research Institute, Division of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Division of Nephrology, Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Open Med (Wars). 2024 Sep 17;19(1):20241035. doi: 10.1515/med-2024-1035. eCollection 2024.
The aim of this study was to investigate iron status and iron deficiency in incident continuous ambulatory peritoneal dialysis (CAPD) patients and identify influencing factors.
Patients with end-stage renal disease were enrolled. Clinical data of iron metabolism and biochemical and dialysis parameters during the first peritoneal dialysis evaluation were collected. Serum ferritin (SF) and transferrin saturation (TSAT) levels were evaluated, and independent influencing factors were identified by correlation and regression analyses.
Of 1,128 adult CAPD patients, 41.2% had iron deficiency (ID), 15.7% had absolute iron deficiency, and 8.2% had functional iron deficiency. The average SF level was (276.8 ± 277.9) μg/L, and iron saturation was (29.8 ± 12.7)%. Additionally, 50.2 and 69.3% of patients reached targets in SF level and iron saturation recommended by the Chinese Society of Nephrology. SF level and TSAT were not correlated with estimated glomerular filtration rate, whereas negatively correlated with platelet count and inflammatory factors. Low platelet count, presence of diabetes mellitus and high interleukin 6 levels were independent factors of lower TSAT.
ID is common in patients with CAPD. Women and those with thrombocytopenia, diabetes, and inflammation are at higher risk for iron storage or reduced iron utilization. In the initial CAPD stage, a reasonable iron supplement strategy may be established for CAPD patients with high-risk factors.
本研究旨在调查新确诊的持续性非卧床腹膜透析（CAPD）患者的铁状态和缺铁情况，并确定影响因素。
纳入终末期肾病患者。收集首次腹膜透析评估时铁代谢、生化及透析参数的临床资料。评估血清铁蛋白（SF）和转铁蛋白饱和度（TSAT）水平，通过相关性和回归分析确定独立影响因素。
在1128例成年CAPD患者中，41.2%存在缺铁（ID），15.7%为绝对缺铁，8.2%为功能性缺铁。SF平均水平为（276.8±277.9）μg/L，铁饱和度为（29.8±12.7）%。此外，50.2%和69.3%的患者达到了中国肾脏病学会推荐的SF水平和铁饱和度目标。SF水平和TSAT与估计肾小球滤过率无关，而与血小板计数和炎症因子呈负相关。血小板计数低、患有糖尿病和白细胞介素6水平高是TSAT降低的独立因素。
ID在CAPD患者中很常见。女性以及血小板减少、糖尿病和炎症患者铁储存或铁利用减少的风险更高。在CAPD初始阶段，可为有高危因素的CAPD患者制定合理的补铁策略。
