Associations Among Serum Transferrin Levels, Markers of Malnutrition, and Mortality in Hemodialysis Patients
Bibliographic record
Abstract
ABSTRACT Introduction A serum transferrin (transferrin) level below 200 mg/dL has been suggested as an indicator of malnutrition in hemodialysis (HD) patients. We investigated the relationships among transferrin levels, various markers of malnutrition, and 1‐year mortality in this patient population. Methods We assessed transferrin, ferritin, and transferrin saturation (TSAT) five times over 1 year. We also measured baseline serum albumin, C‐reactive protein (CRP), geriatric nutritional risk index (GNRI), Kt/Vurea, post‐dialysis body composition (using bioimpedance analysis), and 1‐year mortality. Findings Our study included 431 HD patients (mean age: 67 ± 11 years; median dialysis duration: 67 [35–138] months; diabetes prevalence: 45%). Patients with baseline transferrin ≥ 200 mg/dL had consistently and significantly higher transferrin concentrations throughout the study ( p < 0.001). Compared to patients with baseline transferrin < 200 mg/dL ( n = 285), those with baseline transferrin ≥ 200 mg/dL ( n = 146) showed significantly higher serum albumin (3.7 [3.4–3.9] vs. 3.4 [3.1–3.7] g/dL), GNRI (95 [90–98] vs. 90 [85–95]), and lean tissue index (11.2 [9.5–13.3] vs. 10.3 [9.0–12.1] kg/m 2 ). Conversely, they had significantly lower TSAT (22% ± 12% vs. 27% ± 14%), ferritin (74 ± 79 vs. 172 ± 148 ng/mL), and CRP ( p < 0.01 for all). Baseline serum albumin, Kt/Vurea, and the presence of diabetes were significant determinants of having a baseline transferrin level ≥ 200 mg/dL ( p < 0.05). Over the 1‐year period, 45 all‐cause deaths occurred among the 431 patients. Patients with baseline transferrin ≥ 200 mg/dL had a significantly higher cumulative 1‐year survival rate ( p < 0.05). Furthermore, baseline transferrin was a significant predictor of 1‐year all‐cause mortality in HD patients (hazard ratio: 0.99; p < 0.05). Discussion Our findings indicate that HD patients with baseline transferrin ≥ 200 mg/dL exhibit a better nutritional status than those with transferrin < 200 mg/dL. Moreover, baseline transferrin serves as a significant predictor for 1‐year mortality in HD patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".