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

Ha Nguyen Thi Thu; Hung Nguyen Van; Tuan Nguyen Minh; Kien Nguyen Trung; Thang Le Viet

doi:10.2147/IJGM.S446115

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

Int J Gen Med. 2024 Jan 12:17:105-113. doi: 10.2147/IJGM.S446115. eCollection 2024.

Authors

Ha Nguyen Thi Thu¹, Hung Nguyen Van², Tuan Nguyen Minh³, Kien Nguyen Trung⁴, Thang Le Viet¹

Affiliations

¹ Department of Selection, Preparation and Treatment, Organ Transplant Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam.
² Nephrology and Hemodialysis Department, Transport Hospital, Ha Noi, Vietnam.
³ Nephrology, Urology and Hemodialysis Department, E Hospital, Ha Noi, Vietnam.
⁴ Hematology and Blood Transfusion Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam.

Abstract

Aim: 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; mortality prediction; plasma TIBC; plasma ferritin; the first 3 years of maintenance hemodialysis.