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

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 Pati...

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Bibliographic Details
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
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Summary: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 
ISSN:0902-4441
1600-0609
DOI:10.1111/j.1600-0609.2012.01783.x