Ferritin as a predictor of decline in residual renal function in peritoneal dialysis patients

Background/Aims: Inflammation is an important factor in renal injury. Ferritin, an inflammatory marker, is considered an independent predictor of rapid renal progression in patients with chronic kidney disease. However, the relationship between ferritin and residual renal function (RRF) in patients undergoing peritoneal dialysis (PD) remains unclear. Methods: We reviewed the medical records of patients who started PD between June 2001 and March 2012 at Soonchunhyang University Bucheon Hospital, Korea. A total of 123 patients were enrolled in the study. At 1 month after the initiation of PD, RRF was determined by a 24-hour urine collection and measured every 6 months thereafter. Clinical and biochemical data at the time of the initial 24-hour urine collection were considered as baseline. Results: The RRF reduction rate was significantly greater in patients with high ferritin (ferritin ${\geq}250ng/mL$) compared with those with low ferritin (ferritin < 250 ng/mL;$-1.71{pm}1.36mL$/min/yr/$1.73m^2$ vs. $-0.84{pm}1.63mL$/min/yr/$1.73m^2$, respectively; p = 0.007). Pearson correlation analysis revealed a significant negative correlation between the baseline serum ferritin level and the RRF reduction rate (r = -0.219, p = 0.015). Using multiple linear regression analysis and adjusting for other risk factors, baseline serum ferritin was an independent factor for the RRF reduction rate (${\beta}$ = -0.002, p = 0.002). Conclusions: In this study we showed that a higher ferritin level was significantly associated with a more rapid RRF decline in patients undergoing PD.