title: Serum ferritin is associated with progression of peripheral arterial disease in hemodialysis patients.
abstract: BACKGROUND
  Dialysis patients received intravenous iron to treat anemia and had high prevalence of peripheral artery disease (PAD). We hypothesized that high iron status might associate with the progression of PAD among hemodialysis patients. Therefore, we evaluated the relationship between iron status and progression of PAD.
  
  
  METHODS
  We measured iron status in 74 hemodialysis patients and studied the association with clinical, biochemical, and vascular parameters including progression of PAD measured by ankle-brachial index (ABI) over 3 years.
  
  
  RESULTS
  Mean baseline ABI was 1.03 ± 0.18. Mean ABI at 3 years was 0.95 ± 0.20. Mean ∆ABI (change in ABI after 3 years) was -0.08 ± 0.14. Serum ferritin was negatively correlated with baseline ABI (r = -0.232, p = 0.046). After 3 years, ∆ABI was negatively associated with 3-year averaged serum ferritin, phosphorus, and calcium-phosphate product (Ca × P) (r = -0.253, p = 0.029; r = -0.278, p = 0.016; r = -0.288, p = 0.013; respectively). After an adjusted model, 3-year averaged serum ferritin and Ca × P remained the significant determinants of ∆ABI (β = -0.234, p = 0.038; β = -0.271, p = 0.017; respectively). ∆ABI was significantly different between 3-year averaged serum ferritin level ≥600 and <600 ng/mL (p = 0.032).
  
  
  CONCLUSIONS
  In hemodialysis patients, high serum ferritin associates with progression of PAD, especially among those with high Ca x P level.
authors.affiliation: Department of Diagnostic Radiology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
authors.forename: Chen-Tung
authors.initials: CT
authors.lastname: Lien
authors.affiliation: Department of Biotechnology, Southern Taiwan University, No. 1, Nan-Tai Street, Yung-Kung, Tainan, Taiwan.|Department of Neurology, Chi-Mei Medical Center, No. 901, Zhonghua Rd., Yonykang, Tainan, Taiwan.
authors.forename: Kao-Chang
authors.initials: KC
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
authors.forename: Yueh-Feng
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
authors.forename: Lai-King
authors.initials: LK
authors.lastname: Yu
authors.affiliation: Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
authors.forename: Li-Hsueh
authors.initials: LH
authors.lastname: Huang
authors.affiliation: Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan. chen.chouml@msa.hinet.net.
authors.forename: Chien-An
authors.initials: CA
authors.lastname: Chen
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002130:Calcium Phosphates / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002130:Calcium Phosphates; D010281:Parathyroid Hormone; D005293:Ferritins; D007501:Iron
keywords: Ankle-brachial index; Calcium–phosphate product; Ferritin; Peripheral artery disease