Abstract: SA-PO808

Evaluating Iron Overload in Haemodialysis Patients with MRI T2*

Session Information

Category: Dialysis

  • 605 Dialysis: Anemia and Iron Metabolism

Authors

  • Elyan, Benjamin, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
  • Mangion, Kenneth, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
  • Cockburn, Samantha F, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
  • Mark, Patrick B., Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
  • Rutherford, Elaine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
Background

Intravenous iron is commonly prescribed to hemodialysis (HD) patients but optimal dosing is not established and iron overload is a clinical concern. MRI derived non-contrast T2* time is used to screen for cardiac and liver iron overload in other clinical groups, such as thalassemia - the lower the T2* time, the greater the degree of iron overload. T2* has not been studied in HD patients. We hypothesised that T2* in HD patients would differ from matched healthy volunteers (HVs) and that T2* in HD patients may correlate with their total cumulative intravenous iron doses.

Methods

22 incident HD patients and 26 age and sex matched HVs were enrolled. Participants underwent a 3.0T MRI scan (Siemens Verio). T2* images were blindly analysed offline using Medis analysis software (QMaps) placing regions of interest in the myocardial septum and the liver. Statistical analysis was done using SPSS (version 22).

Results

Liver and myocardial septal T2* times were higher in HD patients (Table 1). Septal T2* times in HD patients negatively correlated with cumulative iron dose (R2 = -0.49 p= 0.017) (Figure 1). Liver T2* times also negatively correlated with cumulative iron dose (R2 = -0.46 p 0.028).

Conclusion

T2* times in septal and liver tissues are higher in incident HD patients compared with HVs, suggesting that HD patients do not have overt signs of iron overload early on. However, greater cumulative iron doses correlated with lower T2* times in HD patients. Imaging signs of iron overload may develop in patients established on HD for longer. Further research should explore the longitudinal affects of cumulative iron dose on T2 * times.

Table 1: Median septal & mean liver T2* times
 HD Patients n=22Healthy Volunteers n=26p-value
T2* septum (ms) (Interquartile Range)31.0 (5.5)23.0 (6.5)<0.001
T2* liver (ms) (95% Confidence Interval)27.5 (24.9, 30.1)19.6 (18.1, 21.0)<0.001

Figure 1: Correlation of average septal T2* time (ms) to cumulative Iron Sucrose dose (mg)

Funding

  • Private Foundation Support