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Evidence for Tissue Iron Overload in Long-term Hemodialysis Patients and the Impact of Withdrawing Parenteral Iron.
MedLine Citation:
PMID:  22435497     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background/Aims:  Erythropoiesis in long-term hemodialyzed (LTH) patients is supported by erythropoietin (rHuEpo) and intravenous iron. This treatment may end-up in iron-overload (IO) in major organs. We studied such patients for parameters of IO in the serum and in major organs. Methods: Patients were treated with rHuEpo (6-8x10(3) units x 1-3/week) and intravenous 100mg ferric saccharate Results:  Out of 115 patients, 21 had serum ferritin (SF) > 1000ng/ml. This group was further analyzed. Their SF and transferrin saturation (TSAT) were 2688±1489ng/ml and 54.2±32.7%, respectively (vs. 125-360ng/ml and 20-50% in normal controls). Serum hepcidin was 60.1±29.5nmol/l (vs. 10.61±6.44nmol/l in controls) (P<0.001). Nineteen patients had increased malonyldialdehyde, a product of lipid peroxidation, indicating oxidative stress. T2* MRI disclosed in 19/21 patients moderate to severe IO in the liver and spleen, in 3/8 patients in the pancreas, but in no patient - in the heart. After stopping IV iron for a mean of 12 months, while continuing rHuEpo, the mean SF decreased in 11 patients to 1682ng/ml and the mean TSAT decreased to 28%, whereas hemoglobin did not change indicating that tissue iron was utilized Conclusion:  High SF correlates with IO in the liver and spleen, but not in the heart © 2012 John Wiley & Sons A/S.
Authors:
Ghoti H; Rachmilewitz E; Simon-Lopez R; Gaber R; Katzir Z; Konen E; Kushnir T; Girelli D; Campostrini N; Fibach E; Goitein O
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-21
Journal Detail:
Title:  European journal of haematology     Volume:  -     ISSN:  1600-0609     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Department of Hematology and Institute of Nephrology, E Wolfson Medical Center, Holon, Israel Beckman Coulter Eurocenter, Nyon, Switzerland Department of Diagnostic Imaging, Sheba Medical Center, Tel-Aviv, Israel Department of Medicine, University of Verona, Italy Department of Hematology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.
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