Korean J Intern Med.  2014 Jul;29(4):489-497.

Ferritin as a predictor of decline in residual renal function in peritoneal dialysis patients

• Hur SM
• Ju HY
• Park MY
• Choi SJ
• Kim JK
• Hwang SD

Abstract

BACKGROUND/AIMS
Aims: Inflammation is an important factor in renal injury. Ferritin, an inflammatory marker, is considered an independent predictor of rapid renal progression in patients with chronic kidney disease. However, the relationship between ferritin and residual renal function (RRF) in patients undergoing peritoneal dialysis (PD) remains unclear.
METHODS
We reviewed the medical records of patients who started PD between June 2001 and March 2012 at Soonchunhyang University Bucheon Hospital, Korea. A total of 123 patients were enrolled in the study. At 1 month after the initiation of PD, RRF was determined by a 24-hour urine collection and measured every 6 months thereafter. Clinical and biochemical data at the time of the initial 24-hour urine collection were considered as baseline.
RESULTS
The RRF reduction rate was significantly greater in patients with high ferritin (ferritin > or = 250 ng/mL) compared with those with low ferritin (ferritin < 250 ng/mL; -1.71 +/- 1.36 mL/min/yr/1.73 m2 vs. -0.84 +/- 1.63 mL/min/yr/1.73 m2, respectively; p = 0.007). Pearson correlation analysis revealed a significant negative correlation between the baseline serum ferritin level and the RRF reduction rate (r = -0.219, p = 0.015). Using multiple linear regression analysis and adjusting for other risk factors, baseline serum ferritin was an independent factor for the RRF reduction rate (beta = -0.002, p = 0.002).
CONCLUSIONS
In this study we showed that a higher ferritin level was significantly associated with a more rapid RRF decline in patients undergoing PD.

Keyword

Ferritins; Peritoneal dialysis; Residual renal function

MeSH Terms

Adult
Aged
Biological Markers/blood
Chi-Square Distribution
Disease Progression
Female
Ferritins/*blood
Hospitals, University
Humans
Inflammation Mediators/*blood
Kaplan-Meier Estimate
Kidney/*physiopathology
Kidney Failure, Chronic/blood/diagnosis/physiopathology/*therapy
Linear Models
Male
Middle Aged
Multivariate Analysis
Peritoneal Dialysis/*adverse effects
Predictive Value of Tests
Proportional Hazards Models
Republic of Korea
Risk Factors
Time Factors
Treatment Outcome
Up-Regulation
Biological Markers
Ferritins
Inflammation Mediators