Evidence for tissue iron overload in long-term hemodialysis patients and the impact of withdrawing parenteral iron

• Published in: European journal of haematology 2012-07, Vol.89 (1), p.87-93
• Main Authors: Ghoti, Hussam, Rachmilewitz, Eliezer A., Simon-Lopez, Ramon, Gaber, Raed, Katzir, Zeev, Konen, Eli, Kushnir, Tamar, Girelli, Domenico, Campostrini, Natascia, Fibach, Eitan, Goitein, Orly
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; anemia; erythropoietin; Erythropoietin - administration & dosage; Female; ferritin; Ferritins - blood; Humans; iron; Iron - administration & dosage; Iron - adverse effects; iron overload; Iron Overload - diagnosis; Iron Overload - etiology; Liver - pathology; long-term hemodialysis; Magnetic Resonance Imaging; Male; Middle Aged; Myocardium - pathology; Pancreas - pathology; Renal Dialysis - adverse effects; Spleen - pathology
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/j.1600-0609.2012.01783.x

Background/aims Erythropoiesis in long‐term hemodialyzed (LTH) patients is supported by erythropoietin (rHuEpo) and intravenous (IV) iron. This treatment may end up in iron overload (IO) in major organs. We studied such patients for the parameters of IO in the serum and in major organs. Methods Patients were treated with rHuEpo (6–8 x 103 units × 1–3/wk) and IV 100 mg ferric saccharate. Results Of 115 patients, 21 had serum ferritin (SF) > 1000 ng/mL. This group was further analyzed. Their SF and transferrin saturation (TSAT) were 2688 ± 1489 ng/mL and 54.2 ± 32.7%, respectively (vs. 125–360 ng/mL and 20–50% in normal controls). Serum hepcidin was 60.1 ± 29.5 nm (vs. 10.61 ± 6.44 nm in controls) (P