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Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study

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Abstract

Background

The mortality in end-stage renal disease patients with dialysis remains high. Serum ferritin is a useful surrogated marker of iron storage. It has not been elucidated whether the ferritin level can predict the prognosis of patients with dialysis but without obvious inflammation. To clarify whether the ferritin level is involved in the prognosis in dialyzed patients, we investigated the relation between ferritin level and mortality in hemodialyzed patients during long-term follow-up.

Methods

Ninety stable hemodialyzed patients were enrolled and followed for 107 months. Serum ferritin and related factors (dialysis, nutrition, iron metabolism, inflammation and oxidative stress) were measured and used for statistical analysis. Survival analysis of death for ferritin as a predictive variable was performed.

Results

A relatively high level of serum ferritin (≥100 ng/ml) was associated with poor prognosis after adjustment for basic factors and C reactive protein (hazard ratio, 4.18). Hemoglobin-stratified Kaplan-Meier analysis showed that the prognosis for the high ferritin-low hemoglobin group was significantly poor.

Conclusion

This study suggests that the ferritin level is closely associated with high mortality in hemodialyzed patients. Further studies investigating the pathological role of iron storage on survival of hemodialyzed patients with large populations are needed.

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Acknowledgments

The authors acknowledge Miho Kimura for the technical assistance in preparing this paper. We thank the subjects, staff and physicians who participated in this study for their cooperation. Pacific Edit reviewed the manuscript prior to submission.

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Authors and Affiliations

  1. Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yukiko Hasuike, Hiroshi Nonoguchi, Masanori Tokuyama, Mana Yahiro, Masayoshi Nanami, Yoshinaga Otaki & Takeshi Nakanishi

  2. Division of Kidney and Dialysis, Meiwa Hospital, Hyogo, Japan

    Mai Ohue & Takanori Nagai

Authors
  1. Yukiko Hasuike
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  2. Hiroshi Nonoguchi
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  3. Masanori Tokuyama
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  4. Mai Ohue
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  5. Takanori Nagai
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  6. Mana Yahiro
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  7. Masayoshi Nanami
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  8. Yoshinaga Otaki
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  9. Takeshi Nakanishi
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Corresponding author

Correspondence to Yukiko Hasuike.

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Hasuike, Y., Nonoguchi, H., Tokuyama, M. et al. Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study. Clin Exp Nephrol 14, 349–355 (2010). https://doi.org/10.1007/s10157-010-0288-x

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  • DOI: https://doi.org/10.1007/s10157-010-0288-x

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