Effects of parenteral iron on inflammation and the myocardium in hemodialysis patients.

Inflammation is a nontraditional cardiovascular risk factor in hemodialysis patients. This pilot study tested the hypothesis that intravenous iron adds to this inflammation by increasing oxidative stress. Secondly, we described the association between iron indices and myocardial structure and function. Thirteen hemodialysis patients from a teaching hospital were recruited for this descriptive study and divided into 3 groups according to their iron profile (high, low, and intermediate). Oxidative stress was determined in vivo by mass spectroscopy with measurement of malondialdehyde (MDA), hexanal, and nonenal. Cardiac magnetic resonance imaging and 2-dimensional echocardiography were used to study any structural or functional changes, respectively. A strong correlation was found between iron indices and oxidative stress (MDA and ferritin r=0.95; p<0.001; MDA and transferrin saturation r=0.80, p<0.01). Magnetic resonance imaging measurements showed a weak correlation with iron indices while no correlation was found between iron indices and echocardiographic measurements. Iron indices are positively correlated with functional oxidative stress. Larger studies are needed to determine the association between inflammation and structural or functional dysfunction of the myocardium.