Older Age and High Serum Ferritin Levels Associated With the Risk of Chronic Cytopenia in Hemodialysis Patients

Abstract

Leukopenia or thrombocytopenia is sometimes observed in end-stage renal disease (ESRD) patients, but the association between chronic leukopenia or thrombocytopenia and hemodialysis (HD) is still unclear. We aimed to investigate the incidence of chronic leukopenia or thrombocytopenia in patients with ESRD who received HD and to determine the risk factors of this complication. We retrospectively analyzed ESRD patients treated with HD at Ditmanson Medical Foundation Chia-Yi Christian Hospital in 2018. The risk factors for the occurrence of chronic leukopenia and thrombocytopenia were analyzed by Cox regression models. Of the 473 patients in our study cohort, 46 (9.7%) patients had a hematologic abnormality, including 18 patients with chronic leukopenia, 18 with chronic thrombocytopenia, and 10 with pancytopenia. Multivariate analysis revealed that patient age ≥60 years at the initiation of dialysis was a significant predictor for both chronic leukopenia [adjusted hazard ratio (aHR), 2.71; 95% confidence interval (CI), 1.06-6.89] and chronic thrombocytopenia (aHR, 2.83; 95% CI, 1.08-7.35). Chronic liver disease (aHR, 3.31; 95% CI, 1.27-8.61) and serum ferritin levels >800 mg/dl (aHR, 3.29; 95% CI, 1.29-8.39) were risk factors for chronic thrombocytopenia. A trend showed that vitamin D from intravenous supplementation (aHR, 0.13; 95% CI, 0.01-1.16, P = 0.066) and serum phosphorous level (aHR, 0.73; 95% CI, 0.53-1.02, P = 0.068) may be associated with chronic thrombocytopenia. Our study demonstrated that hematological abnormality was a long-term complication of HD. These results reveal that older patients with HD and high serum ferritin levels are at an elevated risk for chronic cytopenia. Healthcare professionals should be aware of this risk when treating HD patients in order to improve their prognosis.

Investigation of some Heavy Metals on Parameter of Blood and Oxidative Enzyme in CKD in Iraq-Al-Qadisiyah

“…The results of the current study showed in the age group (40-60) that there was an increase significant at (P< 0.05) in WBC for hemodialysis patients compared with control According to the table indicated (1-1). That's agreement with previous studies [15]. The results of the current study showed in the age group (40-60) that there was an increase significant at (P< 0.05) in WBC for non-hemodialysis patients compared with control According to the table indicated (1).…”

Parathyroidectomy Improves the Consumption of Erythropoiesis-Stimulating Agents in Hemodialysis Patients

“…First, this was a small, single-center retrospectively designed cohort, so selection bias was inevitable. For example, patients who refused PTX were elderly and fragile and were not enrolled [ 15 , 18 ]. Second, we lacked bone marrow and cytogenetic data to measure the degree of bone marrow fibrosis and examine myelodysplastic syndrome, a hematopoietic disease.…”

“…PTX has been reported to improve anemia and reduce the dose of ESA in patients with SHPT, but these data were not consistent [ 12 , 13 , 14 ]. In addition, our previous study suggested that chronic cytopenia was a consequence of long-term hemodialysis but PTX did not reverse or affect the patients’ hematologic profile [ 15 ]. We proposed that this insignificance could be attributed to heterogeneous entities in ESRD.…”

Hyperferritinemia: the link between COVID-19, inflammation, and patient comorbidities

“…The inflammatory state/chronic inflammatory microenvironment is considered a consequence, a trigger, and/or an aggravating factor for the diseases mentioned above, leading to increased patient morbidity and mortality rates and the development of other severe chronic diseases [30 36-39]. Older age and male patients usually have higher serum ferritin levels than younger and female counterparts [40][41][42][43][44][45]. An elevated serum ferritin level in such diseases is considered an inflammatory marker, an acute phase reactant.…”