Kao-Chang Lin1,2, Meng-Yi Tsai3, Chun-Ling Chi4, Lai-King Yu5, Li-Hsueh Huang5, Chien-An Chen6. 1. Department of Biotechnology, Southern Taiwan University, Tainan, Taiwan. 2. Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan. 3. Department of Hematology and Oncology, Tainan Sinlau Hospital, Tainan, Taiwan. 4. Department of Family Medicine, Tainan Sinlau Hospital, Tainan, Taiwan. 5. Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan. 6. Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan. chen.chouml@msa.hinet.net.
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.
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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