Serum ferritin levels predict all-cause and infection-cause 1-year mortality in diabetic patients on maintenance hemodialysis

Am J Med Sci. 2009 Mar;337(3):188-94. doi: 10.1097/MAJ.0b013e31818d8bbe.

Abstract

Background: The aim of this study was to assess the relationship between the serum ferritin level and the 1-year outcome in diabetic maintenance hemodialysis (MHD) patients.

Methods: The prospective clinical study enrolled 187 diabetic MHD patients from a university hospital in Taiwan. All the patients were divided into 3 groups according to their serum ferritin levels: group I (<200 ng/mL; n = 71), group II (200-700 ng/mL; n = 97), and group III (>700 ng/mL; n = 19). A total of 26 demographic, clinical, and laboratory variables were analyzed as predictors of the 1-year mortality.

Results: There were no significant differences between these 3 groups except in their erythropoietin usage, hemoglobin, transferrin saturation, and high-sensitive C-reactive protein levels. The 1-year mortality rates were 9.2%, 11.4%, and 46.2% in groups I, II, and III, respectively. Group I and group II patients had a lower 1-year mortality rate than group III patients (log-rank test; chi = 8.807; P = 0.0112).

Conclusion: The study suggested that serum ferritin levels predict both all-cause and infection-cause 1-year mortality in diabetic patients on MHD. In such patients, the serum ferritin levels are associated with both iron stores and the inflammation status.

MeSH terms

  • Creatinine / blood
  • Diabetic Nephropathies / blood*
  • Diabetic Nephropathies / mortality*
  • Diabetic Nephropathies / therapy
  • Female
  • Ferritins / blood*
  • Humans
  • Infections / mortality*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis / mortality*

Substances

  • Ferritins
  • Creatinine