Serum ferritin, bone marrow iron and mortality rate in CKD patients with different methods of dialysis.

Background and aim: It is well recognized that one of the most significant public health concerns is chronic kidney disease (CKD). In a cohort of incident CKD patients without dialysis, or on hemodialysis (HD), or on peritoneal dialysis (PD), the complicated interactions between bone marrow iron, serum ferritin levels, and death rates were examined.

Materials and methods: For this prospective and observational study, 288 CKD patients who were registered in three institutions between January 2022 and December 2023 were initially recruited. The final analysis comprised 200 patients, chosen based on predetermined inclusion and exclusion criteria.

Results: The median age of all patients was 65.52 ± 8.36, with 102 patients (51%) being male. Of the patients followed up, forty (20%) died. Cardiovascular events accounted for 22.5% of deaths (9 patients), and infections accounted for 70% of deaths. An elevated ferritin level (HR 1.528, 95% CI 1.239-1.885, p < 0.001) and advanced age were important risk factors for infection-related cardiovascular disease.

Conclusions: It was demonstrated that higher blood ferritin levels were substantially linked to a higher risk of death and that the most common causes of death of CKD patients in Iraq are infection-related.