Effect Of Combined Index Of Serum Ferritin(SF) And C Reactive Protein(CRP) On The Prognosis Of Maintenance Hemodialysis Patients

Objective:To explore the effect of serum ferritin(Serum ferritin,SF)combined with C reactive protein(C reactive protein,CRP)on the prognosis of maintenance hemodialysis(MHD)patients,aiming to help stratify the risk of all-cause motality in MHD patients in the future.Methods:117 cases of maintenance hemodialysis patients with regular dialysis time ≥ 3 months in the Department of Nephrology,the Fourth Hospital of Hebei Medical University were included in the study.Followed up these patient until June 2020 and observed their survival.The author measured laboratory indicators,collected demographic data、clinical information of the117 HD patients.SPSS21.0 software was used to analyze on the data.Normally distributed data was represented by x ±s,and comparison between groups was performed by analysis of variance.Non-normally distributed measurement data were represented by M(1/4,3/4),and rank sum test was performed for comparison between groups.Spearman correlation analysis method was used to analyze the correlation between variables,Kaplan-Meier survival analysis method was used to calculate patient survival rate,and Cox proportional hazard model was used for multivariate analysis.Results:During September 2015 to September 2017,117 patients who met the criteria were included in our study,of which the primary disease was mainly composed of chronic glomerulonephritis and diabetic nephropathy.The median follow-up time was 46 months,during which a total of 21 patients died.The main cause of death was cardiovascular and cerebrovascular diseases.The results showed statistical differences in hemoglobin and serum albumin among three groups.Kaplan-Meier survival analysis showed that the median survival time of 117 patients was 46 months.The survival rate of the patients in the group with a high level of both SF and CRP and the group with a high level of either SF or CRP was significantly lower than that of the group with a low level of both SF and CRP,and the difference was statistically significant.The results of Cox regression analysis showed that the risk of all-cause death of patients in the group with a high level of both SF and CRP(HR=16.94,P<0.05)and the group with a high level of either SF or CRP(HR=3.04,P<0.05)was higher than that in the group with a low level of both SF and CRP.After adjustment for hemoglobin and serum albumin,the combined detection of SF/CRP is still strongly correlated with the occurrence of all-cause deaths in patients,and the risk of death in the group with a high level of both SF and CRP is still relatively higher(HR=11.57,P=0.010)than that in the group with a high level of either SF or CRP(HR=3.83,P=0.001).Conclusion:High level of SF or CRP increases the risk of all-cause death in MHD patients,and the combined increase of SF/CRP increases the risk of death more significantly than the single increase of SF/CRP.Combined detection of SF and CRP can help predict the risk of all-cause deaths in MHD patients,and the value is better than any single index of the two.