Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease

Parta Hatamizadeh, Vanessa Ravel, Lilia R. Lukowsky, Miklos Z. Molnar, Hamid Moradi, Kevin Harley, Madeline Pahl, Csaba Kovesdy, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

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Abstract

Background. Anemia is less prominent in patients with polycystic kidney disease (PKD). Such iron indices as ferritin and transferrin saturation (TSAT) values are used to guide management of anemia in individuals on maintenance hemodialysis (MHD). Optimal levels of correction of anemia and optimal levels of TSAT and ferritin are unclear in chronic kidney disease patients and have not been studied specifically in PKD. Methods. We studied 2969 MHD patients with and 128 054 patients without PKD from 580 outpatient hemodialysis facilities between July 2001 and June 2006. Using baseline, timedependent and time-averaged values with unadjusted and multivariable adjusted analysis models, the survival predictabilities of TSAT and ferritin were studied. Results. PKD patients were 58 ± 13 years old and included 46% women, whereas non-PKD patients were 62 ± 15 years old and 45% women. In both PKD and non-PKD patients, a time-averaged TSAT between 30 and 40% was associated with the lowest mortality. Time-averaged ferritin between 100 and <800 ng/mL was associated with the lowest mortality in PKD patients, although this range was 500 to <800 ng/mL in non-PKD patients. Conclusions. In MHD patients with and without PKD, there was a U-shaped relationship between the average TSAT and mortality, and a TSAT of 30-40% was associated with the best survival. However, an average ferritin of 100-800 ng/mL was associated with the best survival in PKD patients, whereas that of non-PKD patients was 500-800 ng/mL. Further studies in PKD and non-PKD patients are necessary to determine whether or not therapeutic attempts to keep TSAT and ferritin levels in these ranges will improve survival.

Original languageEnglish (US)
Pages (from-to)2889-2898
Number of pages10
JournalNephrology Dialysis Transplantation
Volume28
Issue number11
DOIs
StatePublished - Nov 1 2013

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Polycystic Kidney Diseases
Renal Dialysis
Iron
Maintenance
Survival
Transferrin
Ferritins
Kidney Diseases
Anemia
Mortality
Survival Analysis
Chronic Renal Insufficiency

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Hatamizadeh, P., Ravel, V., Lukowsky, L. R., Molnar, M. Z., Moradi, H., Harley, K., ... Kalantar-Zadeh, K. (2013). Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease. Nephrology Dialysis Transplantation, 28(11), 2889-2898. https://doi.org/10.1093/ndt/gft411

Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease. / Hatamizadeh, Parta; Ravel, Vanessa; Lukowsky, Lilia R.; Molnar, Miklos Z.; Moradi, Hamid; Harley, Kevin; Pahl, Madeline; Kovesdy, Csaba; Kalantar-Zadeh, Kamyar.

In: Nephrology Dialysis Transplantation, Vol. 28, No. 11, 01.11.2013, p. 2889-2898.

Research output: Contribution to journalArticle

Hatamizadeh, P, Ravel, V, Lukowsky, LR, Molnar, MZ, Moradi, H, Harley, K, Pahl, M, Kovesdy, C & Kalantar-Zadeh, K 2013, 'Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease', Nephrology Dialysis Transplantation, vol. 28, no. 11, pp. 2889-2898. https://doi.org/10.1093/ndt/gft411
Hatamizadeh, Parta ; Ravel, Vanessa ; Lukowsky, Lilia R. ; Molnar, Miklos Z. ; Moradi, Hamid ; Harley, Kevin ; Pahl, Madeline ; Kovesdy, Csaba ; Kalantar-Zadeh, Kamyar. / Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease. In: Nephrology Dialysis Transplantation. 2013 ; Vol. 28, No. 11. pp. 2889-2898.
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abstract = "Background. Anemia is less prominent in patients with polycystic kidney disease (PKD). Such iron indices as ferritin and transferrin saturation (TSAT) values are used to guide management of anemia in individuals on maintenance hemodialysis (MHD). Optimal levels of correction of anemia and optimal levels of TSAT and ferritin are unclear in chronic kidney disease patients and have not been studied specifically in PKD. Methods. We studied 2969 MHD patients with and 128 054 patients without PKD from 580 outpatient hemodialysis facilities between July 2001 and June 2006. Using baseline, timedependent and time-averaged values with unadjusted and multivariable adjusted analysis models, the survival predictabilities of TSAT and ferritin were studied. Results. PKD patients were 58 ± 13 years old and included 46{\%} women, whereas non-PKD patients were 62 ± 15 years old and 45{\%} women. In both PKD and non-PKD patients, a time-averaged TSAT between 30 and 40{\%} was associated with the lowest mortality. Time-averaged ferritin between 100 and <800 ng/mL was associated with the lowest mortality in PKD patients, although this range was 500 to <800 ng/mL in non-PKD patients. Conclusions. In MHD patients with and without PKD, there was a U-shaped relationship between the average TSAT and mortality, and a TSAT of 30-40{\%} was associated with the best survival. However, an average ferritin of 100-800 ng/mL was associated with the best survival in PKD patients, whereas that of non-PKD patients was 500-800 ng/mL. Further studies in PKD and non-PKD patients are necessary to determine whether or not therapeutic attempts to keep TSAT and ferritin levels in these ranges will improve survival.",
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T1 - Iron indices and survival in maintenance hemodialysis patients with and without polycystic kidney disease

AU - Hatamizadeh, Parta

AU - Ravel, Vanessa

AU - Lukowsky, Lilia R.

AU - Molnar, Miklos Z.

AU - Moradi, Hamid

AU - Harley, Kevin

AU - Pahl, Madeline

AU - Kovesdy, Csaba

AU - Kalantar-Zadeh, Kamyar

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background. Anemia is less prominent in patients with polycystic kidney disease (PKD). Such iron indices as ferritin and transferrin saturation (TSAT) values are used to guide management of anemia in individuals on maintenance hemodialysis (MHD). Optimal levels of correction of anemia and optimal levels of TSAT and ferritin are unclear in chronic kidney disease patients and have not been studied specifically in PKD. Methods. We studied 2969 MHD patients with and 128 054 patients without PKD from 580 outpatient hemodialysis facilities between July 2001 and June 2006. Using baseline, timedependent and time-averaged values with unadjusted and multivariable adjusted analysis models, the survival predictabilities of TSAT and ferritin were studied. Results. PKD patients were 58 ± 13 years old and included 46% women, whereas non-PKD patients were 62 ± 15 years old and 45% women. In both PKD and non-PKD patients, a time-averaged TSAT between 30 and 40% was associated with the lowest mortality. Time-averaged ferritin between 100 and <800 ng/mL was associated with the lowest mortality in PKD patients, although this range was 500 to <800 ng/mL in non-PKD patients. Conclusions. In MHD patients with and without PKD, there was a U-shaped relationship between the average TSAT and mortality, and a TSAT of 30-40% was associated with the best survival. However, an average ferritin of 100-800 ng/mL was associated with the best survival in PKD patients, whereas that of non-PKD patients was 500-800 ng/mL. Further studies in PKD and non-PKD patients are necessary to determine whether or not therapeutic attempts to keep TSAT and ferritin levels in these ranges will improve survival.

AB - Background. Anemia is less prominent in patients with polycystic kidney disease (PKD). Such iron indices as ferritin and transferrin saturation (TSAT) values are used to guide management of anemia in individuals on maintenance hemodialysis (MHD). Optimal levels of correction of anemia and optimal levels of TSAT and ferritin are unclear in chronic kidney disease patients and have not been studied specifically in PKD. Methods. We studied 2969 MHD patients with and 128 054 patients without PKD from 580 outpatient hemodialysis facilities between July 2001 and June 2006. Using baseline, timedependent and time-averaged values with unadjusted and multivariable adjusted analysis models, the survival predictabilities of TSAT and ferritin were studied. Results. PKD patients were 58 ± 13 years old and included 46% women, whereas non-PKD patients were 62 ± 15 years old and 45% women. In both PKD and non-PKD patients, a time-averaged TSAT between 30 and 40% was associated with the lowest mortality. Time-averaged ferritin between 100 and <800 ng/mL was associated with the lowest mortality in PKD patients, although this range was 500 to <800 ng/mL in non-PKD patients. Conclusions. In MHD patients with and without PKD, there was a U-shaped relationship between the average TSAT and mortality, and a TSAT of 30-40% was associated with the best survival. However, an average ferritin of 100-800 ng/mL was associated with the best survival in PKD patients, whereas that of non-PKD patients was 500-800 ng/mL. Further studies in PKD and non-PKD patients are necessary to determine whether or not therapeutic attempts to keep TSAT and ferritin levels in these ranges will improve survival.

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DO - 10.1093/ndt/gft411

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JF - Nephrology Dialysis Transplantation

SN - 0931-0509

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