<p>Serum Ferritin Independently Predicts the Incidence of Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus</p>

Abstract

Aim: This study aimed to determine whether serum ferritin (SF) is an independent risk factor of the incidence of chronic kidney disease (CKD) and rapid renal function decline (RFD) in male Tibetan patients with type 2 diabetes mellitus (T2DM). Methods: We performed a retrospective cohort study that included 191 male Tibetan patients with T2DM without CKD. Patients were divided into three groups according to the level of SF. The following outcomes were measured: cumulative incidence of chronic kidney disease [i.e. estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m 2 and/ or urinary albumin/creatine ratio (ACR) ≥30 mg/g] and RFD (i.e. decrease in eGFR of ≥25% from baseline or a decline rate of ≥3 mL/min per 1.73 m 2 annually). Results: In total, over a median follow-up period of 23 months, 30 (15.7%) and 89 patients (46.6%) developed CKD and RFD. In multivariable Cox models, a 100 ng/mL increment in SF was associated with a 1.12-fold (95% CI: 1.02-1.24) higher adjusted risk for incidence of CKD. The adjusted-HR of CKD was 1.31 (95% CI: 0.38-4.53) and 2.92 (95% CI: 0.87-9.77) for those in tertile 2 and tertile 3, respectively, compared with the patients in tertile 1. However, SF was not significantly associated with RFD (adjusted-HR: 1.06, 95% CI: 0.99-1.14). Conclusion: Serum ferritin independently predicts the incidence of CKD in male Tibetan patients with T2DM. High levels of serum ferritin may play a role in the pathogenesis leading to the development of CKD in T2DM.

Associations between higher plasma ferritin and hepcidin levels with liver stiffness in patients with type 2 diabetes: An exploratory study

“…Our findings may have important clinical implications as the identification of T2DM patients with NAFLD and mildly elevated plasma ferritin levels might identify a subset of individuals at higher risk of having fibrotic NAFLD. In addition, it should be noted that higher plasma ferritin levels are associated with an increased risk of adverse cardiovascular 18,36,37 and renal outcomes 38 . Therefore, the results of our study highlight the need to early assess and adequately treat all coexisting cardiometabolic risk factors in T2DM patients with NAFLD and elevated ferritin levels, as also supported by a recent international consensus on the definition and classification of metabolic hyperferritinemia 9 .…”

“…In addition, it should be noted that higher plasma ferritin levels are associated with an increased risk of adverse cardiovascular 18,36,37 and renal outcomes. 38 Therefore, the results of our study highlight the need to early assess and adequately treat all coexisting cardiometabolic risk factors in T2DM patients with NAFLD and elevated ferritin levels, as also supported by a recent international consensus on the definition and classification of metabolic hyperferritinemia. 9 Currently, lifestyle intervention (achieving a 5% to 10% weight loss through increased physical activity and a hypocaloric diet with a Mediterranean-style dietary pattern) is the cornerstone of the treatment of NAFLD and may also improve cardiometabolic risk factors and reduce metabolic hyperferritinemia.…”

The Relationship of Hyperferritinemia to Metabolism and Chronic Complications in Type 2 Diabetes

“…Hsu et al 30 showed that hyperferritinemia may be an independent risk factor of nephropathy in patients with T2DM. Wu et al 31 reported that serum ferritin independently predicts the incidence of chronic kidney disease in patients with T2DM. Our study showed that there was a positive correlation between hyperferritinemia and DR, regardless of sex.…”

Serum ferritin level in type 2 diabetic patients with renal dysfunction

“…Overall, we found that TIBC, transferrin, haemoglobin and eGFR were negatively correlated with creatinine. Recently it has been reported that raised levels of serum ferritin may play a role in the pathogenesis leading to the development of CKD in T2DM [13]. Also, serum ferritin level has been found as a prognostic marker for predicting renal recovery in acute kidney injury [14].…”