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Associations between iron markers with hemoglobin and outcomes in peritoneal dialysis patients: results from the PDTAP study

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Pubmed体系：
作者：
Wang Zi[1] * ; Liu Guiling[2] * ; Hao Li[2] ; Li Shaomei[3] ; Pei Huaying[3] ; Zhao Jinghong[4] ; Zhang Ying[4] ; Xiong Zibo[5] ; Liao Yumei[5] ; Li Ying[6] ; Lin Qiongzhen[6] ; Hu Wenbo[7] ; Li Yulin[7] ; Zheng Zhaoxia[8] ; Duan Liping[8] ; Fu Gang[9] ; Guo Shanshan[9] ; Zhang Beiru[10] ; Yu Rui[10] ; Sun Fuyun[11] ; Ma Xiaoying[11] ; Zhao Zhanzheng[12] ; Xiao Jing[12] ; Shen Yulan[13] ; Zhang Yong[13] ; Du Xuanyi[14] ; Ji Tianrong[14] ; Wang Caili[15] ; Deng Lirong[15] ; Yue Yingli[16] ; Chen Shanshan[16] ; Ma Zhigang[17] ; Li Yingping[17] ; Zuo Li[18] ; Zhao Huiping[18] ; Zhang Xianchao[19] ; Wang Xuejian[19] ; Liu Yirong[20] ; Gao Xinying[20] ; Chen Xiaoli[21] ; Li Hongyi[21] ; Du Shutong[22] ; Zhao Cui[22] ; Xu Zhonggao[23] ; Zhang Li[23] ; Chen Hongyu[24] ; Li Li[24] ; Wang Lihua[25] ; Yan Yan[25] ; Ma Yingchun[26] ; Wei Yuanyuan[26] ; Zhou Jingwei[27] ; Li Yan[27] ; Dong Jie[1] ;
机构： [1]Renal Division, Department of Medicine, Peking University First Hospital. Institute of Nephrology, Peking University. Key Laboratory of Renal Disease, Ministry of Health. Key Laboratory of Renal Disease, Ministry of Education, Beijing, China, [2]Renal Division, Department of Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui, China, [3]Renal Division, Department of Medicine, The Second Hospital of Hebei Medical University, Hebei, China, [4]Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University( Third Military Medical University) , Chongqing, China, [5]Renal Division, Department of Medicine, Peking University Shenzhen Hospital, Guangdong, China, [6]Renal Division, Department of Medicine, The Third Hospital of Hebei Medical University, Hebei, China, [7]Renal Division, Department of Medicine, People’s Hospital of Qinghai Province, Qinghai, China [8]Renal Division, Department of Medicine, Handan Central Hospital, Hebei, China [9]Renal Division, Department of Medicine, Peking Haidian Hospital, Beijing, China [10]Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China [11]Renal Division, Department of Medicine, Cangzhou Central Hospital, Hebei, China [12]Renal Division, Department of Medicine, The First Affiliated Hospital of Zhengzhou University, Henan, China [13]Renal Division, Department of Medicine, Beijing Miyun District Hospital, Beijing, China [14]Renal Division, Department of Medicine, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China [15]Renal Division, Department of Medicine, The First Affiliated Hospital of BaoTou Medical College, Neimenggu, China [16]Renal Division, Department of Medicine, People’s Hospital of Langfang, Hebei, China [17]Renal Division, Department of Medicine, People’s Hospital of Gansu, Gansu, China, [18]Renal Division, Department of Medicine, Peking University People’s Hospital, Beijing, China [19]Renal Division, Department of Medicine, Pingdingshan First People’s Hospital, Henan, China [20]Renal Division, Department of Medicine, The First People’s Hospital of Xining, Qinghai, China [21]Renal Division, Department of Medicine, Taiyuan Central Hospital, Shanxi, China [22]Renal Division, Department of Medicine, Cangzhou People’s Hospital, Hebei, China [23]Renal Division, Department of Medicine, First Hospital of Jilin University, Jilin, China [24]Renal Division, Department of Medicine, The People’s Hospital of Chuxiong Yi Autonomous Prefecture, Yunnan, China [25]Renal Division, Department of Medicine, The Second Hospital of Shanxi Medical University, Shanxi, China [26]Renal Division, Department of Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing, China [27]Renal Division, Department of Medicine, Beijing Dongzhimen Hospital, Beijing, China
出处：
DOI： 10.1093/ckj/sfae427
ISSN：

关键词： ferritin PDTAP peritoneal dialysis TSAT

摘要：
Iron metabolism markers, such as transferrin saturation (TSAT) and ferritin, are crucial in anemia management in patients with CKD and those undergoing dialysis, yet optimal levels remain unelucidated.We conducted a prospective multicenter cohort study using data from the nationwide Peritoneal Dialysis Telemedicine-based Management Platform (PDTAP) to analyze TSAT, ferritin, and hemoglobin (Hb) levels, and their associations with mortality in the peritoneal dialysis (PD) population.Our study included 4429 PD patients, analyzing data through restricted cubic splines and Cox regression models, adjusted for multiple confounders. Non-linear associations between Hb levels and TSAT/ferritin were observed. Hb levels increased with TSAT up to 40%, then plateaued, whereas ferritin levels increased with the decline of Hb. Further, ferritin levels above 200 ng/mL were independently linked to increased mortality risk [hazard ratio (HR) 1.207, 95% confidence interval (CI) 1.134-1.286], with this effect decreasing as high-sensitivity C-reactive protein levels rose. This risk was notably significant in patients with a history of cardiovascular disease. A ferritin/Hb ratio >2 was associated with increased risk of mortality after adjusting for demographic, nutritional factors and erythropoiesis agents (HR 1.219, 95% CI 1.144-1.299). The ferritin/Hb ratio demonstrated superior predictive ability for iron responsiveness compared with ferritin alone.Serum ferritin level exceeding 200 ng/mL was indepently associated with a higher risk of martality in Chinese PD population. Monitoring the ferritin/Hb ratio may help assess the relative iron content in the body and provide reference for iron supplementation among patients undergoing PD.© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.

基金：
This study was supported by the Scientific Research Project of Capital Health Development( 2020-2-4079) , CAMS Innovation Fund for Medical Sciences( 2019-I2M-5-046) , National High Level Hospital Clinical Research Funding( Scientific and Technological Achievements Transformation Incubation Guidance Fund Project of Peking University First Hospital) , and National High Level Hospital Clinical Research Funding( High Quality Clinical Research Project of Peking University First Hospital)
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2025]版：
无
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
第一作者：
第一作者机构： [1]Renal Division, Department of Medicine, Peking University First Hospital. Institute of Nephrology, Peking University. Key Laboratory of Renal Disease, Ministry of Health. Key Laboratory of Renal Disease, Ministry of Education, Beijing, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Wang Zi,Liu Guiling,Hao Li,et al.Associations between iron markers with hemoglobin and outcomes in peritoneal dialysis patients: results from the PDTAP study[J].Clinical Kidney Journal.2025,18(4):sfae427.doi:10.1093/ckj/sfae427.
APA：
Wang Zi,Liu Guiling,Hao Li,Li Shaomei,Pei Huaying...&Dong Jie.(2025).Associations between iron markers with hemoglobin and outcomes in peritoneal dialysis patients: results from the PDTAP study.Clinical Kidney Journal,18,(4)
MLA：
Wang Zi,et al."Associations between iron markers with hemoglobin and outcomes in peritoneal dialysis patients: results from the PDTAP study".Clinical Kidney Journal 18..4(2025):sfae427

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