The Different Association between Serum Ferritin and Mortality in Hemodialysis and Peritoneal Dialysis Patients Using Japanese Nationwide Dialysis Registry.
The Different Association between Serum Ferritin and Mortality in Hemodialysis and Peritoneal Dialysis Patients Using Japanese Nationwide Dialysis Registry.
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DOI：
10.1371/journal.pone.0143430
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Tsubakihara Y
中科院分区：
文献类型：
--
作者：
Maruyama Y;Yokoyama K;Yokoo T;Shigematsu T;Iseki K;Tsubakihara Y
监测血清铁蛋白水平被广泛推荐用于透析患者贫血的管理。然而，血清铁蛋白和死亡率之间的关系尚不清楚，也没有在接受腹膜透析（PD）的患者中进行研究。从2007年底日本全国透析登记研究中提取了191，902例透析患者的基线数据（年龄，65 ± 13岁;男性，61.1%;中位透析持续时间，62个月）。结果，如一年死亡率，然后在2008年底使用注册表进行评估。在一年内，共有15，284名（8.0%）患者死亡，其中包括6，210名（3.2%）心血管疾病和2，707名（1.4%）感染相关原因。在接受血液透析（HD）的患者中，较高的基线血清铁蛋白水平与较高的死亡率相关。相反，在PD患者中，血清铁蛋白水平和死亡率之间没有明确的相关性。多因素考克斯回归分析显示，血铁蛋白水平最高的十分位数组患者的全因死亡率和心血管死亡率高于最低的十分位数组（风险比[HR]，1.54; 95%置信区间[CI]，1.31-1.81和HR，1.44; 95%CI，1.13-1.84），而与感染相关死亡率的相关性变得不显著（HR，1.14; 95%CI，0.79-1.65）。使用日本全国性透析登记，较高的血清铁蛋白值与死亡率相关，而不是在PD患者，但在HD患者。
Monitoring of serum ferritin levels is widely recommended in the management of anemia among patients on dialysis. However, associations between serum ferritin and mortality are unclear and there have been no investigations among patients undergoing peritoneal dialysis (PD). Baseline data of 191,902 patients on dialysis (age, 65 ± 13 years; male, 61.1%; median dialysis duration, 62 months) were extracted from a nationwide dialysis registry in Japan at the end of 2007. Outcomes, such as one-year mortality, were then evaluated using the registry at the end of 2008. Within one year, a total of 15,284 (8.0%) patients had died, including 6,210 (3.2%) cardiovascular and 2,707 (1.4%) infection-related causes. Higher baseline serum ferritin levels were associated with higher mortality rates among patients undergoing hemodialysis (HD). In contrast, there were no clear associations between serum ferritin levels and mortality among PD patients. Multivariate Cox regression analysis of HD patients showed that those in the highest serum ferritin decile group had higher rates of all-cause and cardiovascular mortality than those in the lowest decile group (hazard ratio [HR], 1.54; 95% confidence interval [CI], 1.31–1.81 and HR, 1.44; 95% CI, 1.13–1.84, respectively), whereas associations with infection-related mortality became non-significant (HR, 1.14; 95% CI, 0.79–1.65). Using Japanese nationwide dialysis registry, higher serum ferritin values were associated with mortality not in PD patients but in HD patients.