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    Characterization of hepatic and cardiac iron deposition during standard treatment of anaemia in haemodialysis

    Access Status
    Fulltext not available
    Authors
    Holman, R.
    Olynyk, John
    Kulkarni, H.
    Ferrari, P.
    Date
    2017
    Type
    Journal Article
    
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    Citation
    Holman, R. and Olynyk, J. and Kulkarni, H. and Ferrari, P. 2017. Characterization of hepatic and cardiac iron deposition during standard treatment of anaemia in haemodialysis. Nephrology. 22 (2): pp. 114-117.
    Source Title
    Nephrology
    DOI
    10.1111/nep.12735
    ISSN
    1320-5358
    Faculty
    Faculty of Health Sciences
    URI
    http://hdl.handle.net/20.500.11937/46153
    Collection
    • Curtin Research Publications
    Abstract

    Background: Parenteral iron is integral in the treatment of anaemia of chronic kidney disease patients on haemodialysis (HD). However, increased liver iron concentration (LIC) can result from such treatment, and this correlates poorly with serum ferritin or transferrin saturation values. It is unclear whether increased cardiac iron concentration also occurs in this setting. We aimed to evaluate the relationship of intravenous iron supplementation to hepatic and cardiac iron deposition in chronic HD subjects. Methods: A cohort of 10 patients on chronic HD for at least 1 year underwent MRI-based quantitation of hepatic and cardiac iron content to evaluate the relationship between intravenous iron supplements and hepatic and cardiac iron deposition. The results were compared against the cumulative parenteral iron dose and serum iron markers. Results: The median age was 61 years (95% confidence interval (CI) 50–71), HD time 2.5 years (95%CI 2.0–5.3) and cumulative iron dose 4300 mg (95%CI 2110–9045). Hepatic iron concentration was elevated in eight of 10 subjects (median 46 mmol/kg, range 31–76). Cardiac iron levels were within the reference range in all subjects. There was poor correlation between conventional haematinic values and either LIC or cardiac iron levels. None of the study subjects exhibited elevated cardiac iron concentration. Conclusion: Whilst HD patients receiving standard parenteral iron therapy have elevated LICs, this is not associated with cardiac iron deposition. Transferrin saturation and serum ferritin levels are poor markers of either liver or cardiac iron deposition in HD subjects.

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