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Serum ferritin, bone marrow iron and mortality rate in CKD patients with different methods of dialysis
Mohammed Lateef Mohammed Alkhammasi1, Bassam Muayad Alwan Al-Naqdi2, Mina Muayad Alwan Al-Naqdi3
1Al-Shaheed Al-Sadr General Hospital. dr.mohammed.alkhammasi@gmail.com.
Insights
Higher serum ferritin levels in chronic kidney disease (CKD) patients are linked to increased mortality risk. Infections are the primary cause of death in CKD patients, particularly in Iraq.
Area of Science:
- Nephrology
- Public Health
- Internal Medicine
Background:
- Chronic kidney disease (CKD) is a significant global public health issue.
- Understanding factors influencing mortality in CKD patients is crucial for improving outcomes.
- Interactions between iron status (bone marrow iron, serum ferritin) and mortality in CKD require further investigation.
Purpose of the Study:
- To examine the complex relationship between bone marrow iron, serum ferritin levels, and mortality rates in a cohort of incident CKD patients.
- To identify risk factors associated with death in CKD patients undergoing or not undergoing dialysis (hemodialysis or peritoneal dialysis).
Main Methods:
- Prospective, observational study design.
- Recruitment of 288 incident CKD patients across three institutions between January 2022 and December 2023.
- Final analysis included 200 patients meeting specific inclusion and exclusion criteria.
Main Results:
- The study cohort had a median age of 65.52 ± 8.36 years, with 51% males.
- A total of 20% of patients (40 out of 200) died during the follow-up period.
- Infections were the leading cause of death (70%), followed by cardiovascular events (22.5%).
- Elevated serum ferritin levels (HR 1.528, p < 0.001) and advanced age were significant risk factors for infection-related mortality.
Conclusions:
- Higher serum ferritin levels are substantially associated with an increased risk of mortality in CKD patients.
- Infection-related causes are the predominant cause of death among CKD patients in Iraq.
- These findings highlight the importance of monitoring ferritin levels and managing infections in CKD patient care.
Background And Aim:
It is well recognized that one of the most significant public health concerns is chronic kidney disease (CKD). In a cohort of incident CKD patients without dialysis, or on hemodialysis (HD), or on peritoneal dialysis (PD), the complicated interactions between bone marrow iron, serum ferritin levels, and death rates were examined.
Materials And Methods:
For this prospective and observational study, 288 CKD patients who were registered in three institutions between January 2022 and December 2023 were initially recruited. The final analysis comprised 200 patients, chosen based on predetermined inclusion and exclusion criteria.
Results:
The median age of all patients was 65.52 ± 8.36, with 102 patients (51%) being male. Of the patients followed up, forty (20%) died. Cardiovascular events accounted for 22.5% of deaths (9 patients), and infections accounted for 70% of deaths. An elevated ferritin level (HR 1.528, 95% CI 1.239-1.885, p < 0.001) and advanced age were important risk factors for infection-related cardiovascular disease.
Conclusions:
It was demonstrated that higher blood ferritin levels were substantially linked to a higher risk of death and that the most common causes of death of CKD patients in Iraq are infection-related.
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