Hepatic and cardiac iron overload quantified by magnetic resonance imaging in patients on hemodialysis: A systematic review and meta‐analysis

Abstract

Introduction: Few studies have reported hepatic and cardiac iron overload in patients with end-stage renal disease (ESRD), and the current evidence regarding the prevalence is still scarce.Aim: This review aims to estimate the prevalence of hepatic and/or cardiac iron overload quantified by magnetic resonance imaging (MRI) in patients with ESRD who receive hemodialysis (HD), peritoneal dialysis (PD), or have undergone a kidney transplant.Methods: A systematic review with meta-analysis was conducted and reported in line with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. MEDLINE and Embase bibliographic databases were searched using a comprehensive list of controlled vocabulary and keywords to identify relevant studies. All studies reporting the prevalence of hepatic and/or cardiac iron overload quantified by MRI in ESRD patients were considered. The Newcastle-Ottawa scale was used to assess the methodological quality of included studies. To investigate the heterogeneity between studies, random-effect meta-analyses for proportions were used. Results: The review comprised seven studies that included 339 patients. Using meta-analysis, the pooled prevalence of severe and mild to moderate hepatic iron overload quantified by MRI was 0.23 [95%

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

“…Our study found an iron accumulation rate of 76.6% in hemodialysis patients, which is strikingly consistent with a recent meta‐analysis that reported a 75% incidence of iron accumulation in this population 15 . This similarity underscores the prevalent issue of iron overload in hemodialysis patients.…”

“…Patients held their breath for approximately 15 s during image acquisition using a torso coil. The imaging parameters were as follows: TR: 400, TE [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] : 0.8-11.6 (ΔTE = 0.7), flip angle 25 , FOV 375 mm, slice thickness 7 mm, gap value 1, and matrix size 112 Â 122.…”

Narrative review of magnetic resonance imaging in quantifying liver iron load

“…At present, many studies have shown that T 2 * /R 2 * relaxation quantitative methods have good linear correlation when measuring LIC at 1.5 T and 3 T. T 2 * is negatively correlated with LIC. R 2 * is positively correlated with LIC and has shown excellent agreement and reproducibility ( 1 , 4 , 5 , 22 , 23 , 27 , 29 ), and this measurement has become a reliable quantitative assessment of liver iron overload. Figure 1 from Xu et al ( 4 ) shows liver T 2 * measured by different software.…”

Relationship between bone marrow iron load and liver iron concentration in dialysis-associated haemosiderosis

“… 5 , 6 , 7 , 8 , 9 , 10 Recent magnetic resonance imaging (MRI) studies suggest that radiological iron overload is highly prevalent in the haemodialysis population worldwide (up to 75% of patients studied by MRI in a recent meta-analysis). 11 In patients on dialysis, iron accumulation in the liver increases hepcidin production, 9 , 10 which has been associated in epidemiological studies with a risk of cardiovascular events and mortality in this setting. 12 , 13 Moreover, recently, liver iron accumulation by MRI in patients on dialysis has been shown to increase hepatic proton density fat fraction, with the ability to induce or worsen fatty liver disease 14 and to be associated with liver fibrosis at transient elastography.…”