High Ferritin and Low Total Iron-Binding Capacity in Plasma Predict All-Cause Mortality During the First 3 Years of Hemodialysis in Patients with End-Stage Chronic Kidney Disease

Abstract

Ha Nguyen Thi Thu,1 Hung Nguyen Van,2 Tuan Nguyen Minh,3 Kien Nguyen Trung,4 Thang Le Viet1 1Department of Selection, Preparation and Treatment, Organ Transplant Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Nephrology and Hemodialysis Department, Transport Hospital, Ha Noi, Vietnam; 3Nephrology, Urology and Hemodialysis Department, E Hospital, Ha Noi, Vietnam; 4Hematology and Blood Transfusion Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, VietnamCorrespondence: Thang Le Viet, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung, Ha Dong, Ha Noi, Vietnam, Tel [phone], Email [email protected]: To determine all-cause mortality rate and the predictive value of plasma ferritin and total iron-binding capacity (TIBC) concentrations for mortality during the first 3 years of hemodialysis in patients with end-stage chronic renal disease (ESRD).Methods: We conducted a study on 174 ESRD patients (estimated Glomerular Filtration Rate < 15 mL/min/1.73m2). The plasma TIBC level was quantified by the ELISA method in all patients at the time before hemodialysis. Based on TIBC concentration, patients were divided equally into 2 groups. Each group had 87 patients. Patients were initiated on hemodialysis, and patients who died from any cause during the first 3 years of hemodialysis were recorded.Results: The all-cause mortality rate of ESRD patients in the first 3 years of maintenance hemodialysis was 22.9%. Plasma high hs-CRP, high ferritin, and low TIBC concentrations were independent factors associated with all-cause mortality in the patients. Plasma ferritin (cut-off value = 454.2 ng/L) and TIBC (cut-off value = 39.84 μmol/L) were predictors of all-cause mortality, AUC is: 0.772; 0.723, p < 0.001.Conclusion: Plasma ferritin and TIBC were good predictors of all-cause mortality in ESRD patients during the first 3 years of hemodialysis.Keywords: end-stage chronic renal disease, plasma TIBC, plasma ferritin, mortality prediction, the first 3 years of maintenance hemodialysis

Keywords

• end-stage chronic renal disease
• plasma tibc
• plasma ferritin
• mortality prediction
• the first 3 years of maintenance hemodialysis.