IRON OVERLOAD IN HEMODIALYSIS-PATIENTS INCREASES THE RISK OF BACTEREMIA - A PROSPECTIVE-STUDY

The incidence of bacteraemia in relation to the degree of transfusional iron overload was studied prospectively in patients from one haemodialysis unit over a 2-year period, with a total follow-up of 181.3 patient-years in 158 patients. Every 3 months, the patients were classified according to the serum ferritin in one of three groups: <500, 500–1000 or > 1000 μg/l. Twenty-nine episodes of bacteraemia were recorded over 181.3 patient-years (yearly incidence of 0.160). The yearly incidence of bacteraemia was 0.1173 and 0.1101 for ferritin <500 and 500–1000 μg/l (no significant difference), with a cumulative incidence for both groups of 0.1164. In the ferritin > 1000 μg/l group, the incidence was 0.3404 (P≥. 0.005 versus the ferritin ≥ 1000 ug/1 group). After stratification for patient's age (at inclusion in the study) and duration of haemodialysis therapy, the higher incidence of bacteraemia in the ferritin >1000 versus ≥ 1000 μg/l groups persisted (P≥ 0.005). This prospective study confirms previous retrospective studies in showing that acquired transfusional iron overload in haemodialysis is associated with a greater risk of bacteraemia. © 1990 European Dialysis and Transplant Association-European Renal Association.