Elevated serum iron level is a predictor of prognosis in ICU patients with acute kidney injury

Abstract Background: Accumulation of iron is associated with oxidative stress (OS), inflammation and regulated cell death. The above three reactions contribute to the development of acute kidney injury (AKI). Here we aimed to investigate the association between the serum iron level and prognosis in severe patients with AKI.Methods: A total of 483 patients with AKI defined by Kidney Disease: Improving Global Guidelines (KIDGO) were included in this retrospective study. The data was extracted from the single-center Medical Information Mart for Intensive Care Ⅲ (MIMIC-Ⅲ) database. The max serum iron concentration measured after Intensive Care Unit (ICU) admission was defined as the serum iron in the study and divided into three groups (Low group, Middle group, High group). We plotted boxplots and Kaplan–Meier curves and used cox regression analysis to analyze data.Results: In univariable Cox regression analysis, serum iron levels were significantly correlated to the prognosis of AKI patients. After adjusting for confounding variables, higher serum iron level was remained to associate with the increase in 90-day mortality in the multivariable Cox regression analysis. Moreover, the risk of 90-day mortality stepwise increased as the groups of serum iron levels increased in AKI patients.Conclusions: From our study, we investigated that high serum iron level was associated with the increased mortality in severe patients with AKI. Serum iron levels on admission can be a predictor for predicting the prognosis of AKI patients.

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Elevated serum iron level is a predictor of prognosis in ICU patients with acute kidney injury

10.21203/rs.3.rs-23349/v2 ◽

2020 ◽

Author(s):

Jie Shu ◽

Yufeng HU ◽

Xueshu Yu ◽

Jiaxiu Chen ◽

Wenwei Xu ◽

...

Keyword(s):

Acute Kidney Injury ◽

Regression Analysis ◽

Intensive Care ◽

Serum Iron ◽

Cox Regression ◽

Elevated Serum ◽

Kidney Injury ◽

Iron Level ◽

Serum Iron Level ◽

Cox Regression Analysis

Abstract Background Accumulation of iron is associated with oxidative stress (OS), inflammation and regulated cell death. The above three reactions contribute to the development of acute kidney injury (AKI). Here we aimed to investigate the association between the serum iron level and prognosis in severe patients with AKI. Methods A total of 483 patients with AKI defined by Kidney Disease: Improving Global Guidelines (KIDGO) were included in this retrospective study. The data was extracted from the single-center Medical Information Mart for Intensive Care III (MIMIC-III) database. The max serum iron concentration measured after Intensive Care Unit (ICU) admission was defined as the serum iron in the study and divided into three groups (Low group, Middle group, High group). We plotted boxplots and Kaplan–Meier curves and used cox regression analysis to analyze data. Results In univariable Cox regression analysis, serum iron levels were significantly correlated to the prognosis of AKI patients. After adjusting for confounding variables, higher serum iron level was remained to associate with the increase in 90-day mortality in the multivariable Cox regression analysis. Moreover, the risk of 90-day mortality stepwise increased as the groups of serum iron levels increased in AKI patients. Conclusions From our study, we investigated that high serum iron level was associated with the increased mortality in severe patients with AKI. Serum iron levels on admission can be a predictor for predicting the prognosis of AKI patients.

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Author Correction: The U‑shaped association of serum iron level with disease severity in adult hospitalized patients with COVID‑19

Scientific Reports ◽

10.1038/s41598-021-96408-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kentaro Tojo ◽

Yoh Sugawara ◽

Yasufumi Oi ◽

Fumihiro Ogawa ◽

Takuma Higurashi ◽

...

Keyword(s):

Disease Severity ◽

Serum Iron ◽

Hospitalized Patients ◽

Iron Level ◽

Serum Iron Level

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Utilization of Renal Ultrasound for Predicting Obstructive Uropathy in ICU Patients With Acute Kidney Injury

CHEST Journal ◽

10.1378/chest.1992458 ◽

2014 ◽

Vol 146 (4) ◽

pp. 223A ◽

Cited By ~ 1

Author(s):

Syed Amin ◽

Reejis Stephen ◽

David Morris ◽

David Kaufman

Keyword(s):

Acute Kidney Injury ◽

Obstructive Uropathy ◽

Kidney Injury ◽

Renal Ultrasound ◽

Icu Patients

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Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2018-0240 ◽

2019 ◽

Vol 41 (4) ◽

pp. 462-471 ◽

Cited By ~ 4

Author(s):

Kellen Hyde Elias Pinheiro ◽

Franciana Aguiar Azêdo ◽

Kelsy Catherina Nema Areco ◽

Sandra Maria Rodrigues Laranja

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury ◽

Mortality Rates ◽

Icu Patients ◽

Septic Acute Kidney Injury ◽

Observational Cohort ◽

Worse Prognosis

Abstract Acute kidney injury (AKI) has an incidence rate of 5-6% among intensive care unit (ICU) patients and sepsis is the most frequent etiology. Aims: To assess patients in the ICU that developed AKI, AKI on chronic kidney disease (CKD), and/or sepsis, and identify the risk factors and outcomes of these diseases. Methods: A prospective observational cohort quantitative study that included patients who stayed in the ICU > 48 hours and had not been on dialysis previously was carried out. Results: 302 patients were included and divided into: no sepsis and no AKI (nsnAKI), sepsis alone (S), septic AKI (sAKI), non-septic AKI (nsAKI), septic AKI on CKD (sAKI/CKD), and non-septic AKI on CKD (nsAKI/CKD). It was observed that 94% of the patients developed some degree of AKI. Kidney Disease Improving Global Outcomes (KDIGO) stage 3 was predominant in the septic groups (p = 0.018). Nephrologist follow-up in the non-septic patients was only 23% vs. 54% in the septic groups (p < 0.001). Dialysis was performed in 8% of the non-septic and 37% of the septic groups (p < 0.001). Mechanical ventilation (MV) requirement was higher in the septic groups (p < 0.001). Mortality was 38 and 39% in the sAKI and sAKI/CKD groups vs 16% and 0% in the nsAKI and nsAKI/CKD groups, respectively (p < 0.001). Conclusions: Patients with sAKI and sAKI/CKD had worse prognosis than those with nsAKI and nsAKI/CKD. The nephrologist was not contacted in a large number of AKI cases, except for KDIGO stage 3, which directly influenced mortality rates. The urine output was considerably impaired, ICU stay was longer, use of MV and mortality were higher when kidney injury was combined with sepsis.

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ROLE OF SERUM IRON AND ITS ASSOCIATION WITH ANEMIC PREVALANCE AMONG PATIENTS WITH DIFFERENT TYPE OF CANCER

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v5.i5(se).2017.1965 ◽

2017 ◽

Vol 5 (5(SE)) ◽

pp. 37-41

Author(s):

Andrew Pradeep M ◽

Indira G ◽

Sethu Nagarajan R

Keyword(s):

Iron Deficiency ◽

Serum Iron ◽

Physiological Activity ◽

Iron Concentration ◽

Active Role ◽

Control Individual ◽

Iron Level ◽

Serum Iron Level ◽

Immune Effector ◽

Patients With Cancer

Cancer is a group of diseases in which cells are aggressive, invasive and sometimes metastatic. Nutritional status an important factor that contributes to immune competence for which trace minerals plays a crucial role in the biochemical and physiological activity of the system. Trace element a category of minerals essential for the biological system and plays an active role in immune effector mechanism. Normal range of iron essential for body metabolism, iron deficiencies leads to anemia which might complicate the event of tumor genesis. Study involved 50 volunteers (36 females, 14 males) of cancer patients of Mohan Nursing Home Madurai. Serum was collected in the informed consent of the patients. Serum iron level was quantified using Atomic Absorption Spectrophotometer. Study documented percentage deviation of serum iron concentration (85%) with severe anemic prevalence from the control individual (without cancer) and also establish an association of iron deficiency with anemic prevalence. Study documented the existence of Iron deficiency which is the most common cause of anemia worldwide. Iron plays a role in oxygen transfer in cytochromes, protein molecules involved in the production of energy in cells and also exhibit certain properties to facilitate antitumor status. Study concludes that serum iron modulations need to be emphasized to minimize the burdenization of the host with Clinical associated complications of Iron deficiency among patients with cancer.

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The Potential Clinical Significance of the Serum Iron and Ferritin Status in Lung Cancer Patients

journal of nutritional oncology ◽

10.34175/jno202004006 ◽

2020 ◽

Vol 5 (4) ◽

pp. 189-195

Author(s):

Fei Fei Guo ◽

◽

Shi Jia Cheng ◽

Yi Ning Liu ◽

Jiu Wei Cui ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Serum Ferritin ◽

Serum Iron ◽

Serum Ferritin Level ◽

Ferritin Level ◽

Stage Iv ◽

Iron Level ◽

Serum Iron Level ◽

Lung Cancer Patients

Background An increasing number of studies have shown that iron, one of the indispensable trace elements in the human body, is closely related to the occurrence and development of cancer. However, few studies have clearly demonstrated the role of the iron levels in lung cancer patients, or the potential effects of inflammation on iron levels. Methods The clinical data for lung cancer patients and non-lung cancer participants were retrospectively analyzed. The serum iron and ferritin levels were measured and compared using a rank-sum test. The correlation between the serum iron/ferritin and C-reactive protein (CRP) was analyzed by rank correlation. The cut-off values for continuous variables were obtained by the receiver operating characteristic curve (ROC) method. An analysis of potential prognostic factors in lung cancer patients was conducted by univariate and multivariate survival analyses. Results The serum iron levels in patients with extensive small-cell lung cancer (SCLC) were lower than those with limited-stage SCLC, and the levels of serum ferritin and CRP in those with extensive SCLC were higher than those with limited-stage SCLC. Similarly, the serum iron levels in patients with stage IV non-small cell lung cancer (NSCLC) were lower than those of patients with stage Ⅰ-Ⅲ disease, and the levels of serum ferritin and CRP in those with stage IV NSCLC were higher than those in stages Ⅰ-Ⅲ. The serum iron level was negatively correlated with the level of CRP, while the serum ferritin level was positively correlated with CRP. The stage of lung cancer, but not the serum iron/ ferritin level, was an independent prognostic factor in lung cancer patients. Conclusions The serum iron and ferritin levels are associated with the staging of lung cancer. The later stages of lung cancer are associated with a lower serum iron level, a higher serum ferritin level, and a higher CRP level. Inflammation may play an important role in regulating the serum iron and ferritin levels in lung cancer patients.

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Experimental Production of Pyridoxine Deficiency Anemia in Rats

Blood ◽

10.1182/blood.v23.5.679.679 ◽

1964 ◽

Vol 23 (5) ◽

pp. 679-687 ◽

Cited By ~ 9

Author(s):

SHU CHU SHEN ◽

PETER Y. C. WONG ◽

MASSAO OGURO

Keyword(s):

Bone Marrow ◽

Serum Iron ◽

Normal Values ◽

Hypochromic Anemia ◽

Hemoglobin Level ◽

Deficiency Anemia ◽

Iron Level ◽

Experimental Production ◽

Serum Iron Level ◽

Pyridoxine Deficiency

Abstract Rats fed a diet deficient in pyridoxine all exhibited a severe microcytic hypochromic anemia after 40 to 50 weeks. This anemia responded promptly to pyridoxine administration. The myeloid:erythroid ratio in the bone marrow of the severely anemic rats was definitely increased, suggestive of hypoplasia of the erythroid series, after prolonged deprivation of pyridoxine. The ratio was markedly decreased shortly after the inception of pyridoxine treatment, indicating active erythropoiesis induced by therapy; the ratio subsequently returned toward normal when hemoglobin level improved. There was no evidence of accumulation of iron in the bone marrow. The serum iron level increased only slightly, to high-normal values in the anemic rats, but fell to low-normal level after the administration of pyridoxine.

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Serum Iron Level as a Potential Predictor of Coronavirus Disease 2019 Severity and Mortality: A Retrospective Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa250 ◽

2020 ◽

Vol 7 (7) ◽

Cited By ~ 9

Author(s):

Kang Zhao ◽

Jucun Huang ◽

Dan Dai ◽

Yuwei Feng ◽

Liming Liu ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Iron ◽

Iron Status ◽

Iron Concentration ◽

Iron Level ◽

Serum Iron Level ◽

Amyloid A ◽

Significant Difference ◽

Before And After ◽

Low Serum

Abstract Background Various types of pulmonary diseases are associated with iron deficiency. However, information on iron status in coronavirus disease 2019 (COVID-19) is scarce. Methods This study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated. Results The most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein, serum amyloid A, D-dimer, lactate dehydrogenase, urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. Seven (53.8%) patients with a lower serum iron level after treatment in the critical group had died. There was a significant difference in posttreatment serum iron levels between COVID-19 survivors and nonsurvivors. Conclusions Serum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.

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