Serum ferritin is associated with arterial stiffness in hemodialysis patients: results of a 3-year follow-up study.
BACKGROUND
Iron may contribute to vascular injury through reactive oxygen species. Hemodialysis patients frequently receive iron supply for correction of anemia and are at a high risk of cardiovascular disease. We tested the relationship between iron status and change in arterial stiffness in hemodialysis patients.


METHODS
We measured iron status in 53 hemodialysis patients and studied the association with clinical, biochemical, and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) over 3 years. The blood pressure was controlled to below 140/90 mmHg by anti-hypertensive drugs.


RESULTS
Median and interquartile range of baseline baPWV, baPWV at 3 years, and ΔbaPWV (difference between 3-year baPWV and baseline baPWV) were following: 17.6 (14.8-18.9), 16.9 (15.3-19.9), and 0.2 (-1.2 to 2.7) m/s. At baseline, baPWV was positively correlated with age, serum ferritin, and systolic blood pressure in univariate analysis. However, in multivariate analysis, only age and serum ferritin remained the significant determinants of baseline baPWV. After 3 years, ΔbaPWV was negatively correlated with age and positively with 3-year averaged serum ferritin in univariate analysis. Then, in multivariate analysis, only 3-year averaged serum ferritin was the important determinant of ΔbaPWV. ΔbaPWV was significantly increased in patients with 3-year averaged serum ferritin >500 ng/mL compared to patients with 3-year averaged serum ferritin ≤500 ng/mL.


CONCLUSIONS
In hemodialysis patients, serum ferritin associates with the progressive arterial stiffness, especially when serum ferritin >500 ng/mL.
Department of Biotechnology, Southern Taiwan University, Tainan, Taiwan.|Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.
Kao-Chang
KC
Lin
Department of Hematology and Oncology, Tainan Sinlau Hospital, Tainan, Taiwan.
Meng-Yi
MY
Tsai
Department of Family Medicine, Tainan Sinlau Hospital, Tainan, Taiwan.
Chun-Ling
CL
Chi
Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
Lai-King
LK
Yu
Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan.
Li-Hsueh
LH
Huang
Division of Nephrology, Tainan Sinlau Hospital, No. 57, 1 Sec., Dongmen Rd., Tainan, Taiwan. chen.chouml@msa.hinet.net.
Chien-An
CA
Chen
D000367:Age Factors; D000368:Aged; D000740:Anemia / Q000188:drug therapy; D001158:Arteries; D005260:Female; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D059289:Vascular Stiffness
D005293:Ferritins; D007501:Iron
Arterial stiffness; Brachial–ankle pulse wave velocity; Ferritin