ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2018
Association between serum ferritin and mortality: findings from the USA, Japan and European Dialysis Outcomes and Practice Patterns Study.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Role of Serum Ferritin in Predicting Outcomes of COVID-19 Infection Among Sickle Cell Disease Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Efficacy and safety of single high-dose intravenous ferric carboxymaltose in patients undergoing hemodialysis: a multicenter, single-arm, open-label, clinical trial.BMC nephrology · 2026Trial
- Predictors of iron versus erythropoietin responsiveness in anemic hemodialysis patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2022Trial
- Ferric citrate hydrate is associated with a reduced cost of drugs and a smaller change in red blood cell distribution width.Scientific reports · 2022Trial
- The Impact of Intravenous Iron Supplementation on Hematinic Parameters and Erythropoietin Requirements in Hemodialysis Patients.Advances in therapy · 2021Trial
- Randomised clinical trial of ferric citrate hydrate on anaemia management in haemodialysis patients with hyperphosphataemia: ASTRIO study.Scientific reports · 2019Trial
- Etiologic spectrum and early mortality predictors in extreme hyperferritinemia: insights from rheumatology and hematology clinics.Clinical rheumatology · 2026Article
- Targeting biological age with bioactive, microbiota-accessible nutritional complexes: a pilot study on healthspan extension in medically healthy adults.Scientific reports · 2025Article
- The association of iron status on clinical outcomes in peritoneal dialysis: a retrospective study over 10 years.Renal failure · 2025Article
- Construction of a C-reactive protein-albumin-lymphocyte index-based prediction model for all-cause mortality in patients on maintenance hemodialysis.Renal failure · 2025Article
- Associations between iron markers with hemoglobin and outcomes in peritoneal dialysis patients: results from the PDTAP study.Clinical kidney journal · 2025Article
- Article
- Impact of transferrin saturation on cardiovascular events in non-dialysis-dependent chronic kidney disease patients treated with darbepoetin alfa.Journal of nephrology · 2024Observational
- Gut microbial metabolites SCFAs and chronic kidney disease.Journal of translational medicine · 2024Review
- Association of serum ferritin and all-cause mortality in AKI patients: a retrospective cohort study.Frontiers in medicine · 2024Article
- Serum ferritin and neutrophil-to-lymphocyte ratio predict all-cause mortality in patients receiving maintenance hemodialysis: a prospective study.Frontiers in molecular biosciences · 2024Article
- Association of Estimated Total Body Iron with All-Cause Mortality in Japanese Hemodialysis Patients: The Miyazaki Dialysis Cohort Study.Nutrients · 2023Article
- Association between iron status markers and kidney outcome in patients with chronic kidney disease.Scientific reports · 2023Article
- Trends in mortality and comorbidities in hemodialysis patients between 2012 and 2017 in an East-European Country: a retrospective study.International urology and nephrology · 2023Article
- Article
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Authors and funding
10 authors.
Funding
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Abstract
Background: The Kidney Disease: Improving Global Outcomes guidelines have cautioned against administering intravenous (IV) iron to hemodialysis patients with high serum ferritin levels due to safety concerns, but prior research has shown that the association between high ferritin and mortality could be attributed to confounding by malnutrition and inflammation. Our goal was to better understand the ferritin-mortality association and relative influence of IV iron and inflammation in the USA, where ferritin levels have recently increased dramatically, and in Europe and Japan, where ferritin levels are lower and anemia management practices differ. Methods: Data from 18 261 patients in Phases 4 and 5 (2009-15) of the international Dialysis Outcomes and Practice Patterns Study, a prospective cohort study, were analyzed. Using Cox regression, we modeled the association between baseline ferritin and 1-year mortality with restricted cubic splines and assessed the impact of potential confounders. Results: Median ferritin levels were 718 ng/mL in the USA, 405 in Europe and 83 in Japan. High ferritin levels were associated with elevated mortality (relative to region-specific medians) in all three regions. The strength of this association was attenuated more by adjustment for malnutrition and inflammation than by IV iron and erythropoiesis-stimulating agent dose in each region. Conclusion: The utility of high ferritin as a biomarker for clinical risk due to excess iron stores may be limited, although caution regarding IV iron dosing to higher upper ferritin targets remains warranted. Research to resolve biomarker criteria for iron dosing, and whether optimal anemia management strategies differ internationally, is still needed.
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