Intravenous iron therapy as a possible risk factor for atherosclerosis in end-stage renal disease

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Clinical Biochemistry

Background:

• Atherosclerosis, characterized by arterial wall thickening, is a significant concern in dialysis patients.
• Elevated serum ferritin concentration has been proposed as a potential risk factor for atherosclerosis.
• Understanding the impact of iron therapy on atherosclerosis progression is crucial for patient management.

Purpose of the Study:

• To investigate the relationship between intravenous (IV) iron therapy, serum ferritin levels, and carotid intima-media thickness (C-IMT) in dialysis patients.
• To determine if IV iron administration influences atherosclerosis markers in this population.

Main Methods:

• Sixty dialysis patients were categorized into high-risk (Group I) and low-risk (Group II) based on C-IMT measurements via ultrasound.
• Assessed parameters included serum creatinine, urea, calcium, phosphorus, hemoglobin, albumin, uric acid, iron, ferritin, and lipid profiles.
• Correlations were analyzed between C-IMT, serum ferritin levels, and the cumulative dose of IV iron received over 24 months.

Main Results:

• Higher ferritin levels were observed in the high-risk group (Group I) compared to the low-risk group (Group II) (581 ± 303 vs. 306 ± 224, P < 0.001).
• A significant positive correlation was found between C-IMT and serum ferritin levels (r = 0.315, P = 0.015).
• C-IMT also correlated significantly with the cumulative IV iron dose received in the preceding 24 months (r = 0.471, P = 0.001).

Conclusions:

• Intravenous iron therapy and elevated serum ferritin levels are associated with an increased incidence of atherosclerosis in dialysis patients.
• These findings suggest that iron management in dialysis patients warrants careful consideration to mitigate cardiovascular risk.
• Further research is needed to elucidate the precise mechanisms linking iron overload and atherosclerosis progression.