Abstract: PUB131
Serum Transferrin Levels Predict Hemodialysis (HD) Adequacy and Mortality in Patients on Maintenance Hemodialysis
Session Information
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Karasuda, Kazuyoshi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
Background
Tarantino et al. reported that transferrin levels can be used to evaluate 3 important factors (Kt/Vurea, geriatric nutritional index [GNRI], and C-reactive protein [CRP]) in 78 hemodialysis (HD) patients. We investigated if transferrin levels can predict HD adequacy and mortality.
Methods
Subjects were 454 HD patients. Clinical data including serum transferrin, transferrin saturation (TSAT), ferritin, Kt/Vurea, predialysis β2-microglobulin (β2MG), serum albumin, GNRI, CRP, Agatston coronary artery calcium score (CACS), and postdialysis body composition using bioelectrical impedance were assessed at baseline. The patients were followed up for 400 days.
Results
Age, the dialysis duration, and the prevalence of diabetes in all patients were 72±13 years, 66 (35–134) months, and 44.7%, respectively. Patients with transferrin levels ≥200 mg/dL (n=152) had a significantly lower age (69±13 vs. 73±13 years), TSAT (19 [13–27] vs. 24 [18–31] %), ferritin (73±78 vs. 170±145 ng/mL), CRP (0.11 [0.04–0.34] vs. 0.19 [0.06–0.63] mg/dL), β2MG (26.7 [22.9–31.3] vs. 28.1 [24.8–31.8] mg/L), and extracellular water/total body water, but higher serum albumin levels (3.7 [3.4–3.9] vs. 3.4 [3.1–3.7] g/dL), GNRI (93±7 vs. 88±9), and lean tissue index (12.2 [10.7–14.2] vs. 11.1 [9.7–13.0] kg/m2) than patients with transferrin levels <200 mg/dL (n=302) (P <0.05). Sex, dialysis duration, prevalence of diabetes, Kt/Vurea, and CACS were not significantly different between the 2 groups. Multiple linear regression showed that serum albumin levels, CRP levels, and Kt/Vurea were significant determinants for transferrin levels (P <0.001). Kaplan–Meier analysis showed a better 1-year survival rate in patients with transferrin levels ≥200 mg/dL than patients with transferrin levels <200 mg/dL (P <0.01). After adjusting for age, sex, dialysis duration, diabetes, serum albumin and CRP, transferrin levels were a significant predictor for 1-year all-cause mortality in HD patients (hazard ratio: 0.99, P <0.05).
Conclusion
In patients on maintenance HD, measurement of serum transferrin levels can be used to evaluate Kt/Vurea, albumin, and CRP. Patients with transferrin levels ≥200 mg/dL had higher 1-year survival rate than patients with transferrin levels <200 mg/dL, despite the presence of iron deficiency.
Funding
- Private Foundation Support