ArticlePloS one2015
Reassessment of Iron Biomarkers for Prediction of Dialysis Iron Overload: An MRI Study.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 61 citations in OpenAlex.
- Trial
- Targets for adapting intravenous iron dose in hemodialysis: a proof of concept study.BMC nephrology · 2017Trial
- Correlation Between Hepatic Iron and Fat in Hemodialysis Patients: A Quantitative MRI Analysis.Kidney medicine · 2025Article
- High Serum Ferritin Levels Are Associated with Sarcopenia in Patients Undergoing Chronic Hemodialysis.Nutrients · 2025Article
- Characteristics of T cell premature senescence in maintenance hemodialysis patients.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024Article
- Article
- Liver Iron Overload Drives COVID-19 Mortality: a Two-Sample Mendelian Randomization Study.Biological trace element research · 2024Article
- Anemia of Chronic Kidney Disease-A Narrative Review of Its Pathophysiology, Diagnosis, and Management.Biomedicines · 2024Review
- Article
- Association between iron status markers and kidney outcome in patients with chronic kidney disease.Scientific reports · 2023Article
- Managing Anemia: Point of Convergence for Heart Failure and Chronic Kidney Disease?Life (Basel, Switzerland) · 2023Review
- Successful Treatment of Refractory Anemia in a Patient With Glycogen Storage Disease Type Ia Undergoing Hemodialysis.Cureus · 2022Article
- Article
- Narrative Review of Hyperferritinemia, Iron Deficiency, and the Challenges of Managing Anemia in Aboriginal and Torres Strait Islander Australians With CKD.Kidney international reports · 2021Review
- The Superiority of T2*MRI Over Serum Ferritin in the Evaluation of Secondary Iron Overload in a Chronic Kidney Disease Patient: A Case Report.Journal of blood medicine · 2021Article
- Article
- Review
- Liver Iron Load Influences Hepatic Fat Fraction in End-Stage Renal Disease Patients on Dialysis: A Proof of Concept Study.EBioMedicine · 2019Observational
- When should iron supplementation in dialysis patients be avoided, minimized or withdrawn?Seminars in dialysis · 2019Article
- Association between serum ferritin and mortality: findings from the USA, Japan and European Dialysis Outcomes and Practice Patterns Study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesIron overload among hemodialysis patients was previously considered rare but is now an increasingly recognized clinical situation. We analyzed correlations between iron biomarkers and the liver iron concentration (LIC) measured by magnetic resonance imaging (MRI), and examined their diagnostic accuracy for iron overload. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We performed a prospective cross-sectional study from 31 January 2005 to 31 August 2013 in the dialysis centre of a French community-based private hospital. A cohort of 212 hemodialysis patients free of overt inflammation or malnutrition, were treated for anemia with parenteral iron-sucrose and an erythropoesis-stimulating agent, in keeping with current clinical guidelines. Blinded measurements of hepatic iron stores were performed by T1 and T2* contrast MRI, and relationships were analysed using Spearman's coefficient, logistic regression and receiver-operator characteristic (ROC) curves.
resultsAmong the biological markers, only serum ferritin showed a strong correlation with LIC (rho= 0.52, 95% CI: 0.41-0.61, p< 0.0001, Spearman test). In logistic analysis, only serum ferritin correctly classified the overall cohort into patients with normal liver iron stores (LIC ≤ 50 μmol/g) and those with elevated liver iron stores (LIC > 50 μmol/g) (odds ratio 1.007; 95% CI: 1.004-1.010). Serum ferritin was the iron biomarker with the best discriminatory capacity in ROC curves analysis (area under the curve (AUC) = 0.767; 95% CI: 0.698-0.835). The optimal serum ferritin cutoffs were 160 μg/L for LIC > 50 μmol/g (mild iron overload) and 290 μg/L for LIC > 200 μmol/g (severe iron overload).
conclusionsFor clinical purposes, serum ferritin correctly reflects liver iron stores, as assessed by MRI, in hemodialysis patients without overt inflammation or malnutrition. These results strongly suggest that current ferritin target values should be lowered to avoid iron overload.
trial registrationISRCTN Registry 80100088.
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