Could Serum Ferritin Be Simple Prognostic Tool in Cirrhosis?
A recent study by Alok Ranjan and colleagues, published in BMC Gastroenterology (2025), suggests that serum ferritin levels may serve as a simple and effective prognostic marker for complications in patients with cirrhosis. The retrospective cohort study analyzed cirrhotic patients and found that higher serum ferritin concentrations were strongly associated with an increased likelihood of hepatic complications. Patients with ferritin levels of 45 ng/mL or higher had nearly six times the odds of developing complications compared to those with lower levels. Additionally, ferritin concentrations tended to rise with worsening disease severity, peaking in patients classified as Child-Pugh B.
The researchers also explored other factors that could influence cirrhosis outcomes. Hyponatremia and vitamin D deficiency emerged as independent predictors of hepatic complications, further reinforcing the multifactorial nature of disease progression. However, the simplicity and accessibility of serum ferritin testing make it a particularly attractive tool for early risk stratification. According to the study, routine measurement of ferritin could help clinicians identify high-risk patients who may benefit from closer monitoring or timely intervention, potentially improving overall management and reducing the burden of cirrhosis-related complications.
From a clinical perspective, incorporating serum ferritin as a prognostic marker could enhance patient care by providing an easily obtainable laboratory measure that reflects disease severity and predicts future complications. The authors emphasize that while ferritin alone should not replace comprehensive assessment, it can be a valuable adjunct to established scoring systems such as Child-Pugh and MELD. By identifying patients at higher risk earlier, healthcare providers may be able to intervene proactively, adjust therapies, and improve patient outcomes. These findings highlight the potential for ferritin to become a practical, cost-effective tool in the management of cirrhosis.
Keywords: cirrhosis, serum ferritin, prognostic marker, hepatic complications, Child-Pugh score, liver disease, risk stratification
