Assessment of Hepatic Iron Deposition by MRI Among Patients with ESRD on Regular Hemodialysis

Abstract

nemia in hemodialysis patients with parenteral iron management in conjunction with or prior to therapy with ESA is routinely used to treat this condition. Iron overload is a recognized complication of anemia therapy in the dialysis population. MRI T2* provides accurate reproducible and noninvasive technique for assessing hepatic iron concentration saving the patients from invasive biopsy which considered the reference standard for assessment of liver iron, but it is limited by high cost, sampling variability, and invasiveness. The accuracy and precision of T2* MRI quantification method have been shown in several previous studies in non-CKD patients comparing T2*-LIC with liver biopsy-LIC. Also presence of liver fibrosis did not affect the accuracy of our technique. Studies using quantitative MRI methods indicate that the intravenous iron dose is associated with evidence of hepatic iron overload and reveal that current serum iron markers are inadequate to identify patients at risk of iron overload as we discussed that multiple factors can contribute serum iron markers elevation other than iron overload as duration of dialysis with long term intravenous iron therapy that play the crucial role of development of hepatic iron overload also presence of chronic HCV infection participate in hepatic iron deposition. It is important to diagnose cases with hepatic iron A