Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 29;15(9):2149.
doi: 10.3390/nu15092149.

Elevated Ferritin Levels Associated with High Body Fat Mass Affect Mortality in Peritoneal Dialysis Patients

Hyung Seok Lee  1 , Hye-Mi Noh  2 , Jung Nam An  1 , Young Rim Song  1 , Sung Gyun Kim  1 , Jwa-Kyung Kim  1
Affiliations

Elevated Ferritin Levels Associated with High Body Fat Mass Affect Mortality in Peritoneal Dialysis Patients

Hyung Seok Lee et al. Nutrients. .

Abstract

Obesity is a common health problem in peritoneal dialysis (PD) patients and causes high serum ferritin levels. However, mixed results have been reported on whether serum ferritin levels affect the prognosis of PD patients. We investigated the effect of increased adiposity on ferritin levels and its association with mortality in 350 well-nourished PD patients. Body composition was measured using a portable whole-body bioimpedance spectroscope, and clinical determinants of high ferritin levels were evaluated. High ferritin levels (≥600 ng/mL) were observed in 63 (18.0%) patients. Patients with high ferritin levels had a significantly higher body fat percentage and a lower lean tissue index than patients with low or normal ferritin levels. During a median follow-up of 30 months, there were 65 deaths. Ferritin ≥ 600 ng/mL was associated with significantly higher all-cause mortality compared with 200-600 ng/mL of ferritin. Multivariate analysis showed that high ferritin levels were significantly associated with a higher percentage of body fat after adjustment for lean tissue index and volume status. High ferritin increased all-cause mortality in PD patients, and increased fat mass was an important determinant of the high ferritin. Our results support that adiposity may lead to an adverse clinical outcome in PD patients.

Keywords: ferritin; inflammation; mortality; obesity; peritoneal dialysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparisons of gender-specific body fat percentage, fat tissue index, lean tissue index, and BMI by ferritin levels ≥ 600 ng/mL and <600 ng/mL. Patients in the high ferritin group had significantly more fat than those in the low ferritin group. Differences in lean tissue index were observed only in male patients. BMI did not differ by ferritin level.
Figure 2
Figure 2
(A,B) Mortality differed significantly among three ferritin groups (<200, 200–599, ≥600 ng/mL). Patients in the high ferritin group had the worst survival rate among PD patients. (C) To determine the prognostic role of high ferritin levels independent of anemia, the patients were divided into four groups according to ferritin levels of 600 ng/mL and hemoglobin levels of 10.0 g/dL. (D) High ferritin levels increased mortality rates regardless of hemoglobin levels, but the highest mortality rates were observed in patients with high ferritin combined with low hemoglobin.
Figure 3
Figure 3
Mediation analysis results are β (p-value), indirect effect is β (standard error), 95% confidence interval.
See this image and copyright information in PMC

References

    1. Mehrotra R., Devuyst O., Davies S.J., Johnson D.W. The Current State of Peritoneal Dialysis. J. Am. Soc. Nephrol. 2016;27:3238–3252. doi: 10.1681/ASN.2016010112. - DOI - PMC - PubMed
    1. Himmelfarb J., Vanholder R., Mehrotra R., Tonelli M. The current and future landscape of dialysis. Nat. Rev. Nephrol. 2020;16:573–585. doi: 10.1038/s41581-020-0315-4. - DOI - PMC - PubMed
    1. Kang M., Kim Y.L., Kang E., Ryu H., Kim Y.C., Kim D.K., Lee H., Han S.S., Joo K.W., Kim Y.S., et al. Evolving outcomes of peritoneal dialysis: Secular trends at a single large center over three decades. Kidney Res. Clin. Pract. 2021;40:472–483. doi: 10.23876/j.krcp.21.020. - DOI - PMC - PubMed
    1. Hsu C.C., Huang C.C., Chang Y.C., Chen J.S., Tsai W.C., Wang K.Y. A comparison of quality of life between patients treated with different dialysis modalities in Taiwan. PLoS ONE. 2020;15:e0227297. doi: 10.1371/journal.pone.0227297. - DOI - PMC - PubMed
    1. Wang A.Y., Brimble K.S., Brunier G., Holt S.G., Jha V., Johnson D.W., Kang S.W., Kooman J.P., Lambie M., McIntyre C., et al. ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I—Assessment and Management of Various Cardiovascular Risk Factors. Perit. Dial. Int. 2015;35:379–387. doi: 10.3747/pdi.2014.00279. - DOI - PMC - PubMed

LinkOut - more resources