The prevalence of functional iron deficiency and its impact on mortality in patients receiving hemodialysis.

BACKGROUND

Chronic kidney disease (CKD) is a major global public health concern and has reached epidemic proportions worldwide, including in our country. Iron deficiency and functional iron deficiency (FID) are common among CKD patients. The objective of this study was to examine the prevalence of FID and its effect on mortality in hemodialysis (HD) patients.

METHODS

A retrospective observational study was conducted between 2010 and 2024 in patients receiving HD in our hospital. Patients who had been on HD for at least three months were included in the study. Exclusion criteria included peritoneal dialysis, home HD, and age under 18 years.

RESULTS

The study included 3184 patients receiving HD (mean age 64.4 ± 13.5 years; 58% male). FID was present in 448 patients (14.1%), while absolute iron deficiency (AID) was identified in 123 (3.9%) of the patients. The overall survival was 97% at 3 months, 85% at 12 months, and 44% at 60 months in patients with FID. Mortality was significantly higher in the FID group compared to other groups (p < 0.05). When we investigated the related factors with mortality in patients with FID, we found that female sex, diabetes mellitus history, and serum albumin levels at diagnosis were the independent factors associated with mortality in patients with FID.

CONCLUSIONS

The prevalence of FID was determined to be 14.1% in our study. Survival rates in patients with FID declined markedly over time, highlighting the adverse prognostic impact of this condition. Early recognition of FID and careful management of modifiable risk factors, particularly nutritional status, may help improve survival in this high-risk population.