Iron overload in hemodialysis patients: Comparison of serum iron parameters with T2*MRI sequence

Purpose: To evaluate correlation between serum iron parameters and liver T2* value in hemodialysis patients with iron overload due to parenteral iron therapy.Materials and methods: We evaluated 30 hemodialysis patients using a multiecho T2*-weighted MRI sequence. Age, sex, duration of dialysis, iron and erythropoietin doses taken in the past year, and serum iron parameters were recorded. Liver T2* values were averaged from three distinct liver regions. A T2* value of 33 +/- 7 ms is considered normal. Declines below 24, 21, and 14 ms signify iron overload grades 1, 2, and 3, respectively.Results: There was no statistically significant difference comparing the measurements of 3 different ROIs (p > 0.05). A total of 23 patients (76.6%) had iron overload. Serum ferritin levels of patients with iron overload were significantly higher than those without iron overload (687.25 [186.5-1489] ng/mL vs. 371.25 [127.5-542.5] ng/mL, p = 0.008). No linear correlation was observed between age, dialysis duration, serum iron metrics, medication doses, and T2* values. Likewise, no significant differences were found among patients based on iron overload status or its grades concerning these parameters.Conclusion: While standard serum markers might overlook iron overload, elevated ferritin levels are promising. MRI reliably detects iron overload in patients receiving parenteral iron.