Different Effects of Iron Indices on Mortality in Patients With Autosomal Dominant Polycystic Kidney Disease After Long-Term Hemodialysis: A Nationwide Population-Based Study

Yeh, Shu Ching; Lin, Yi Chun; Hong, Ying; Hsu, Chih Cheng; Lin, Yong-Song; Wu, Mai Szu

doi:10.1053/j.jrn.2018.11.004

Cited by 9 publications

(13 citation statements)

References 22 publications

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“…In case of functional ID/anemia, high ferritin levels with a value of > 100–500 or 109–2783 μg/L indicated a higher risk of mortality and cardiovascular hospitalization [ 66 , 67 ]. In contrast, low TSAT values were significantly associated with a higher mortality risk independent of absolute or functional ID/anemia [ 68 , 71 – 73 ]. In an analysis of approx.…”

Section: Iron Deficiency Diagnosis and Outcome In Chronic Diseasesmentioning

confidence: 99%

How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome

2023

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Iron deficiency (ID) is the most common nutritional disorder worldwide. It is often observed in patients with chronic diseases, such as heart failure (HF), chronic kidney disease (CKD), inflammatory bowel disease (IBD) and cancer. ID is associated with poor clinical outcome, including poor performance, reduced quality of life, as well as increased hospitalization and mortality. The aim of this review is to provide an overview about the role of ID in chronic diseases (HF, CKD, IBD, cancer) regarding their current definitions and clinical relevance; diagnostic accuracy of iron parameters in chronic inflammatory conditions and its potential as prognostic markers. Due to different definitions and guideline recommendations of ID, various laboratory parameters for ID diagnostic exist and there is no general consensus about the definition of ID and its treatment. Still, a general trend can be observed across all investigated indications of this review (HF, CKD, IBD, cancer) that serum ferritin and transferrin saturation (TSAT) are the two parameters mentioned most often and emphasized in all guidelines to define ID and guide treatment. The most commonly used threshold values for the diagnosis of ID are TSAT of < 20% and serum ferritin of < 100–300 µg/L. Noteworthy, both TSAT and particularly ferritin are frequently applied, but both may vary due to inflammatory conditions. Studies showed that TSAT is less affected by inflammatory processes and may therefore be more accurate and reliable than serum ferritin, particularly in conditions with elevated inflammatory state. A low iron status and particularly a low TSAT value was associated with a poor outcome in all investigated indications, with the strongest evidence in HF patients. Routine surveillance of iron status in these groups of patients with chronic conditions is advisable to detect ID early. Depending on the inflammatory state, TSAT < 20% may be the more accurate diagnostic marker of ID than ferritin. Moreover, TSAT may also be the more reliable estimate for the prognosis, particularly in HF.

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Section: Iron Deficiency Diagnosis and Outcome In Chronic Diseasesmentioning

confidence: 99%

How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome

2023

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“…Haemodialysis, 28 and peritoneal dialysis. 29 Abbreviations: CKD, chronic kidney disease; ESRD, end-stage renal disease; ESKD, end-stage kidney disease; TWRDS, Taiwan Renal Data System.…”

Section: Subjectmentioning

confidence: 99%

Taiwan renal data report system: Framework, function, and development

Lin,

Liao,

Lin

et al. 2023

Nephrology

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The world healthcare system is actively seeking possible solutions for the rapid growth of kidney disease threats. The Taiwan Renal Data System (TWRDS) was central in assisting kidney health and care policymaking to reduce end‐stage kidney disease incidence and mortality. This article summarizes the TWRDS framework, recent applications, and developments to provide new insights for some international researchers to promote planetary kidney health. The TWRDS originated in 1987 for the accreditation and quality monitoring of dialysis units and was connected with enriched health claim databases after the implementation of universal national health insurance in Taiwan in 1995. As a healthcare information centre, TWRDS has published annual reports forming indispensable instructions for renal care improvement since 2014. The TWRDS possesses three main functions: (1) kidney disease surveillance; (2) offering rich materials for research purposes; (3) achieving precision prevention and care through complex algorithms. In the new era, TWRDS can help build a more resilient society against communicable disease threats by integrating remote sensor techniques for developing future remote healthcare structures, as well as identifying kidney health inequity populations and promoting healthcare resources distributed equity. The global healthcare system is facing escalating burdens of non‐communicable disease care due to the rapidly growing elderly population. Therefore, a considerable‐scale data system is an essential decision‐supportive tool in promoting an evidence‐based, resilient, sustainable, equity care environment. Undoubtedly, TWRDS experience is a practical example of leveraging healthcare providers' decisions, care outcomes, and renovation.

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“…Furthermore, the long-term toxicity of IV iron treatment is also unknown [2]. In some studies, a high serum ferritin level was associated with increased mortality in hemodialysis patients [3][4][5][6][7]. In these studies, different values were identified for the serum ferritin level that could cause an increase in mortality [3,6,7].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021

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Introduction: The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. Methods: A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin <800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin >1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. Results: Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, p = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; p = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; p = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; p = 0.063). Conclusion: Time-averaged serum ferritin levels >1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

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Different Effects of Iron Indices on Mortality in Patients With Autosomal Dominant Polycystic Kidney Disease After Long-Term Hemodialysis: A Nationwide Population-Based Study

Cited by 9 publications

References 22 publications

How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome

How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome

Taiwan renal data report system: Framework, function, and development

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

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