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Serum ferritin is associated with arterial stiffness in hemodialysis patients: results of a 3-year follow-up study

  • Nephrology - Original article
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Abstract

Background

Iron may contribute to vascular injury through reactive oxygen species. Hemodialysis patients frequently receive iron supply for correction of anemia and are at a high risk of cardiovascular disease. We tested the relationship between iron status and change in arterial stiffness in hemodialysis patients.

Patients and methods

We measured iron status in 53 hemodialysis patients and studied the association with clinical, biochemical, and arterial stiffness measured by brachial–ankle pulse wave velocity (baPWV) over 3 years. The blood pressure was controlled to below 140/90 mmHg by anti-hypertensive drugs.

Results

Median and interquartile range of baseline baPWV, baPWV at 3 years, and ΔbaPWV (difference between 3-year baPWV and baseline baPWV) were following: 17.6 (14.8–18.9), 16.9 (15.3–19.9), and 0.2 (−1.2 to 2.7) m/s. At baseline, baPWV was positively correlated with age, serum ferritin, and systolic blood pressure in univariate analysis. However, in multivariate analysis, only age and serum ferritin remained the significant determinants of baseline baPWV. After 3 years, ΔbaPWV was negatively correlated with age and positively with 3-year averaged serum ferritin in univariate analysis. Then, in multivariate analysis, only 3-year averaged serum ferritin was the important determinant of ΔbaPWV. ΔbaPWV was significantly increased in patients with 3-year averaged serum ferritin >500 ng/mL compared to patients with 3-year averaged serum ferritin ≤500 ng/mL.

Conclusions

In hemodialysis patients, serum ferritin associates with the progressive arterial stiffness, especially when serum ferritin >500 ng/mL.

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Author notes

    Authors and Affiliations

    1. Department of Biotechnology, Southern Taiwan University, Tainan, Taiwan

      Kao-Chang Lin

    2. Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan

      Kao-Chang Lin

    3. Department of Hematology and Oncology, Tainan Sinlau Hospital, Tainan, Taiwan

      Meng-Yi Tsai

    4. Department of Family Medicine, Tainan Sinlau Hospital, Tainan, Taiwan

      Chun-Ling Chi

    5. Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan

      Lai-King Yu, Li-Hsueh Huang & Chien-An Chen

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    1. Kao-Chang Lin
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    Correspondence to Chien-An Chen.

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    Kao-Chang Lin and Meng-Yi Tsai have contributed equally to this work.

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    Lin, KC., Tsai, MY., Chi, CL. et al. Serum ferritin is associated with arterial stiffness in hemodialysis patients: results of a 3-year follow-up study. Int Urol Nephrol 47, 1847–1853 (2015). https://doi.org/10.1007/s11255-015-1090-1

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    • DOI: https://doi.org/10.1007/s11255-015-1090-1

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