Nephrol Dial Transplant (2002) 17: 25-29
© 2002 European Renal Association-European Dialysis and Transplant Association
Iron overload and cardiovascular complications in dialysis patients
Division of Nephrology and Dialysis, Department of Medicine, University of Vienna, Austria
Abstract
Patients with end-stage renal disease (ESRD) are at a markedly increased risk for cardiovascular complications compared with the general population. In addition to traditional cardiovascular risk factors such as diabetes mellitus, hypertension, hyperlipidaemia or cigarette smoking, a number of population-specific factors are implicated, such as anaemia, hyperhomocysteinaemia, hyperphosphataemia and vascular calcification, as well as inflammation and oxidative stress. Iron overload has been suggested to increase the cardiovascular risk in the general population. Iron supplementation is a widespread clinical practice in ESRD, especially in patients on maintenance haemodialysis (HD). Iron may therefore contribute to cardiovascular complications through effects on low-density lipoprotein oxidation and endothelial dysfunction. Although the effects of iron stores and iron therapy on cardiovascular risk are not well defined in HD patients, the ‘iron hypothesis’ deserves attention: serum ferritin is a marker of morbidity and mortality in HD patients, and the administration of high amounts of intravenous iron increases the risks of hospitalization and death. In contrast to intravenous iron therapy, intestinal iron absorption is regulated by body iron stores and is suppressed in the presence of infection and iron overload. Prospective studies are needed to clarify the influence of iron stores and iron therapy on overall and cardiovascular morbidity and mortality in ESRD patients.
Keywords: cardiovascular; dialysis; iron
Notes
Correspondence and offprint request to: Josef Kletzmayr, MD, Division of Nephrology and Dialysis, Department of Medicine III, University of Vienna, Währinger Gürtel 18–20, A-1090 Vienna, Austria. Email: josef.kletzmayr{at}akh\|[hyphen]\|wien.ac.at
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. David, P. Kumpers, G. M. Eisenbach, H. Haller, and J. T. Kielstein Prospective evaluation of an in-centre conversion from conventional haemodialysis to an intensified nocturnal strategy Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2232 - 2240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Gill Cardiovascular Disease in Transplant Recipients: Current and Future Treatment Strategies Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(Supplement_2): S29 - S37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Wang, G. Geraci, M. K. Kuhlmann, N. W. Levin, and G. J. Handelman Chemical reactions of vitamin C with intravenous-iron formulations Nephrol. Dial. Transplant., January 1, 2008; 23(1): 120 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Chisholm, C. A. Spivey, and L. L. Mulloy Effects of a medication assistance program with medication therapy management on the health of renal transplant recipients Am. J. Health Syst. Pharm., July 15, 2007; 64(14): 1506 - 1512. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ersoy Antioxidant treatment in dialysis patients-- importance of ferritin Nephrol. Dial. Transplant., July 1, 2006; 21(7): 2035 - 2036. [Full Text] [PDF]
|
|