{"id":"dddf43e0ae33","type":"article","url":"https://hartvaat.nl/2026/10/01/stijgend-ferritine-of-aanhoudende-ijzeroverbelasting-voorspelt-geen-overleving-b/","title":"Stijgend ferritine of aanhoudende ijzeroverbelasting voorspelt geen overleving bij peritoneale dialysepatiënten","title_en":"The Impact of Persistent Iron Overload and Ferritin Trend on the Clinical Outcome of Peritoneal Dialysis Patients: A Retrospective Study Over 10 Years.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","internist"],"tags":[],"journal":"Kidney medicine","doi":"10.1016/j.xkme.2026.101463","source_url":"https://doi.org/10.1016/j.xkme.2026.101463","authors":["Vanessa Wing-Lam Tao","Vickie Wai-Ki Kwong","Jack Kit-Chung Ng","Winston Wing-Shing Fung","Gordon Chun-Kau Chan","Wing-Fai Pang","Kai-Ming Chow","Cheuk-Chun Szeto"],"significance":4,"published":"2026-09-15","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/kdigo-richtlijn-ckd-2024/","https://hartvaat.nl/kennis/cardiometabool/bloedsuikerdoelen-cardiovasculair/"],"congress":"","summary_en":"A single-center retrospective study of 586 new peritoneal dialysis patients examined whether persistent iron overload or changes in serum ferritin levels affect survival and clinical outcomes. After multivariable adjustment, a ferritin rise >750 ng/mL was not significantly associated with patient survival, and reversing iron overload after the first year did not improve clinical endpoints. These findings suggest that aggressive iron monitoring and supplementation in peritoneal dialysis may not translate to better survival, warranting a cautious approach to iron therapy in this population.","created":"2026-09-08T01:08:54Z","updated":"2026-09-08T01:08:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve single-center studie onder 586 nieuwe peritoneale dialysepatiënten onderzocht de invloed van ferritinetrends en aanhoudende ijzeroverbelasting op overleving en complicaties. Na correctie voor confounders bleek een stijging van het ferritine > 750 ng/mL niet significant geassocieerd met patiëntoverleving, en ook het omkeren van ijzeroverbelasting na het eerste jaar verbeterde de klinische uitkomsten niet. Voor de dagpraktijk betekent dit dat intensieve ijzermonitoring en -therapie bij PD-patiënten niet automatisch leidt tot betere overlevingskansen, wat voorzichtigheid gebiedt bij het doseren van ijzersuppletie.","abstract_original":"RATIONALE & OBJECTIVE: Anemia is a major complication in chronic kidney disease. Although iron replacement therapies are commonly used, concerns about iron overload exist, for which data are limited, particularly in patients undergoing peritoneal dialysis (PD). This study investigated the impact of persistent iron overload and ferritin trends on clinical outcomes. STUDY DESIGN: Single-center retrospective study. SETTING & PARTICIPANTS: A single dialysis unit; 586 new adult patients undergoing PD between 2011 and 2020; a subgroup of 345 patients was analyzed using their persistent or reversal of high iron status. PREDICTORS: Change in iron status in 12 months after start of PD, classified into 5 groups. OUTCOMES: Patient survival, technique survival, peritonitis-free survival, and number and length of hospitalization. ANALYTICAL APPROACH: Cox regression models for survival analysis; linear regression after log transformation for hospitalization. RESULTS: The 3-year patient survival rates for groups of patients with a decrease or increase in serum ferritin levels of ≤ 250 ng/mL, a decrease in serum ferritin levels of > 250-750 ng/mL, a decrease in serum ferritin levels of > 750 ng/mL, an increase in serum ferritin levels of > 250-750 ng/mL, and an increase in serum ferritin levels of > 750 ng/mL were 84.0%, 77.3%, 79.2%, 81.1%, and 67.3%, respectively (P = 0.007), although the association became insignificant after adjusting for confounding factors. Notably, 70.0% of a subgroup had persistent iron overload after the first year of PD. There were no significant differences in survival rates among the control, persistent iron overload, and reversal groups. LIMITATIONS: Single-center retrospective study. CONCLUSIONS: A rise in serum ferritin levels of > 750 ng/mL was not associated with patient survival in a multivariable analysis. For patients with iron overload at the initiation of PD, the reversal of iron overload was not associated with any improvement in clinical outcomes."}