대한신장학회

논문분류	춘계학술대회 초록집
제목	Relationships of Iron Status with Echocardiographic Parameters and Cardiac Biomarkers in Incident Dialysis Patients
저자	Hyang Mo Koo1, Eun Jin Kim1, Jae Hyun Han1, Ji Suk Han1, Jung Tak Park1,Hyung Jung Oh1, Seung Hyeok Han1, Tae-Hyun Yoo1, Yong-Lim Kim2,Yon Su Kim3, Chul Woo Yang4, Nam-Ho Kim5, Shin-Wook Kang1
출판정보	2013; 2013(1):
키워드	트랜스페린 포화도, 심장 초음파, 심장 표지자/Transferrin saturation, Echocardiography, Cardiac biomarker
초록	Background: Transferrin saturation (TSAT) is the ratio of serum iron to total iron-binding capacity, multiplied by 100, and is closely associated with hemoglobin (Hb) levels. Meanwhile, anemia is mostly accompanied in patients with end-stage renal disease (ESRD) on dialysis, and its impact on cardiovascular (CV) events and mortality has been extensively investigated. However, little is known about the consequence of TSAT on the clinical outcome in dialysis patients. Methods: A prospective cohort of 879 incident dialysis patients with anemia from 36 dialysis centers of the Clinical Research Center for ESRD in Korea were selected for this study. Patients were divided into 7 groups according to the baseline TSAT; <10%, ≥60%, and every 10% increment in between, and all-cause mortality was compared among the groups. In addition, the relationship of TSAT with echocardiographic findings and inflammatory and cardiac biomarkers were clarified. Results: There were no differences in Hb concentrations and the proportion of patients on erythropoietin stimulating agents or iron supplements among the groups. During a mean follow-up duration of 19.4 months, 57 patients (6.2%) died, and CV disease-related death was the most common cause. Compared to patients with TSAT 30-40%, the hazard ratios (HRs) for all-cause mortality in TSAT <10%, TSAT 10-20%, TSAT 20-30%, and TSAT 50-60% groups were 3.17 (p=0.04), 4.57(p=0.02), 3.13 (p=0.08), and 3.29 (p=0.21), respectively. Logistic regression analysis revealed that patients with TSAT <10% had a significantly low odds ratio (OR) for ejection fraction ≥60% (OR=0.47, p=0.04) and a high OR for left ventricular hypertrophy (OR=1.84, p=0.09). In addition, the OR for increased high sensitivity C-reactive protein levels (≥3 mg/dL) was significantly higher in patients with TSAT <10% (OR=4.15, p<0.001). TSAT <10% was also associated with a high risk of increased Nterminal pro-B-type natriuretic peptide concentrations (≥10,000 pg/mL) without a statistical significance (OR=2.34, p=0.07). Moreover, patients with TSAT <10%, 10-20%, and 20-30% were at significantly greater risks for increased Troponin-T levels (≥0.1 ng/mL) (<10%, OR=2.35, p=0.04; 10-20%, OR=2.06, p=0.04; 20-30%, OR=2.52, p=0.006). Conclusion: Extremely low TSAT was associated with high all-cause mortality in incident dialysis patients, which may be attributed to its relationship with inflammation and cardiac dysfunction.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정