Ferritin and Cardiac Electrophysiology in End-Stage Renal Disease: Evaluating the Impact of Index of Cardio-Electrophysiological Balance

Authors : Metin Çoksevim, Ömer Kertmen, Ufuk Yıldırım, Ercan Türkmen

Pages : 37-44

Doi:10.52827/hititmedj.1595243

View : 35 | Download : 16

Publication Date : 2025-02-25

Article Type : Research Paper

Abstract :Objective: Ferritin is a critical protein involved in iron storage and functions as an acute-phase reactant, playing a significant role in chronic inflammation and the pathogenesis of cardiovascular diseases. Elevated ferritin levels in end-stage renal disease patients undergoing hemodialysis may influence cardiac electrophysiological parameters, such as the corrected index of cardio-electrophysiological balance, a marker of proarrhythmic risk. This study aimed to investigate the association between ferritin levels and the corrected index of cardio-electrophysiological balance in patients with end-stage renal disease undergoing hemodialysis. Material and Method: This retrospective cross-sectional study included 438 patients with end-stage renal disease undergoing hemodialysis, categorized into two groups according to their ferritin levels: Group 1 (≥1000 ng/mL, n=254) and Group 2 (≤200 ng/mL, n=184). Demographic, biochemical, and electrocardiographic data, including corrected index of cardio-electrophysiological balance, were analyzed. The correlation between ferritin levels and the corrected index of cardio-electrophysiological balance was assessed. Results: The index of cardio-electrophysiological balance was significantly higher in Group 1 compared to Group 2 (5.1 vs. 4.9, p=0.003). A moderate positive correlation between ferritin levels and the index of cardio-electrophysiological balance was identified (r=0.326, p<0.005). While significant differences were observed in heart rate, QRS duration, and PR intervals between the groups, other electrocardiographic parameters, such as Tp-e and QT intervals, did not show significant differences. The logistic regression analysis identified gender and ferritin levels as significant predictors of elevated iCEBc (≥4.5) (Ferritin odds ratio of 1.08 (95% CI: 1.03–1.12, p<0.005). Conclusion: Elevated ferritin levels in end-stage renal disease patients undergoing hemodialysis are associated with an increased corrected index of cardio-electrophysiological balance, reflecting heightened proarrhythmic risk. These findings underscore the importance of ferritin as a potential marker for arrhythmia risk assessment in this population. Further research is warranted to explore strategies for mitigating cardiovascular risks associated with iron metabolism dysregulation.
Keywords : Ferritin, hemodiyaliz, Kardiyo-Elektrofizyolojik Denge İndeksi, Son dönem böbrek hastalığı.

ORIGINAL ARTICLE URL