Table 1 Correlations between iron parameters and adverse clinical outcomes in critically ill patients
From: Iron as an emerging therapeutic target in critically ill patients
Main pathology and cohort size | Iron parameters measured | Conclusion | Year |
|---|---|---|---|
Acute Kidney Injury | |||
483 (AKI) | Serum iron Transferrin Ferritin | Serum iron higher than 60 µg·dL−1 (i.e., 10.7 µM) was associated with higher short- and long-term mortality | 2020 [90] |
121 (critically ill patients) | Plasma iron Transferrin and TSAT Ferritin Free hemoglobin Plasma catalytic iron | High plasma catalytic iron was correlated with a greater risk of AKI, RRT and mortality | 2014 [7] |
807 (AKI requiring RRT) | Plasma iron Transferrin and TSAT Ferritin Free hemoglobin Plasma catalytic iron | Higher plasma catalytic iron and lower hepcidin were associated with a greater risk of death | 2019 [5] |
Sepsis | |||
176 critically ill patients (57% with sepsis and 25% with septic shock) | Plasma catalytic iron | The severity of multiorgan dysfunction and the probability of death were associated with plasma catalytic iron and lipid peroxidation | 2022 [96] |
112 (septic) + 43 (nonseptic) | Serum iron Transferrin and TSAT Ferritin Hepcidin | Low iron (< 10.5 μM) and low TSAT (< 55%) were associated with short- and long-term survival | 2016 [8] |
61 (sepsis) | Serum iron Transferrin and TSAT Ferritin | Higher serum iron upon ICU admission, higher TSAT and lower transferrin were associated with higher mortality | 2020 [92] |
1891 (including 324 in septic shock) | Serum iron Transferrin Ferritin | Higher serum iron was independently associated with increased 90-day mortality | 2018 [91] |
Liver disease | |||
120 (ACLF) + 20 (DC) + 20 (healthy patients) | Serum iron Transferrin and TSAT Ferritin Hepcidin Cellular LIP | Iron metabolism and transport were dysregulated in ACLF patients, and more so in those with MOF. TSAT, hepcidin, and labile iron pool in macrophages correlate with disease severity | 2015 [93] |
292 (DC) | Serum iron Transferrin and TSAT Ferritin Hepcidin | Lower serum transferrin and higher TSAT correlated with poor short-term prognosis in patients with manifested organ failure | 2017 [94] |
286 (End-stage liver disease) | Transferrin Ferritin | High serum ferritin and lower serum transferrin were associated with greater 90-day mortality | 2019 [97] |
Cardiac procedure | |||
301 (cardiac surgery) | TSAT Ferritin Urine hepcidin | Higher TSAT and lower ferritin at 1Â h of cardiopulmonary bypass were associated with the development of AKI | 2019 [98] |
14 (cardiac surgery) | Urine catalytic iron Urine NGAL | Evolution of increased urine catalytic iron and NGAL during cardiopulmonary bypass were correlated and may be indicative of early AKI | 2013 [51] |
250 (cardiac surgery) | Plasma iron Transferrin and TSAT Ferritin Free hemoglobin Plasma catalytic iron | Patients with the highest catalytic iron concentrations after operation had greater odds of AKI, hospital mortality, and postoperative myocardial injury | 2015 [6] |
806 (ACS and undergoing contrast exposure) | Catalytic iron | Catalytic iron was associated with increased mortality at 30Â days. Contrast nephropathy was correlated with increased catalytic iron and mortality | 2013 [99] |
COVID-19 | |||
120 | Serum iron TSAT Ferritin Hepcidin Serum catalytic iron | Serum catalytic iron was positively associated with in-hospital mortality after adjusting for age and sex | 2021 [100] |
31 | Serum iron TSAT Ferritin Trasnferrin | TSAT is extremely reduced at ICU admission and then significantly increases at days 3 to 6 | 2020 [101] |
75 (associated with mucormycosis) | Serum iron Ferritin Hepcidin TIBC | Clinical severity of COVID-19-associated mucormycosis (CAM) was correlated with higher mortality and increased serum iron levels | 2023 [102] |