Abstract: During the past 2 decades, routine use of recombinant erythropoiesis-stimulating agents (ESAs) has enabled anemia to be corrected in dialysis patients, thereby improving their quality of life and permitting better outcomes. As successful use of ESA requires sufficient available iron, almost all end-stage renal disease patients on ESA now receive concomitant parenteral iron therapy. Radiologists must be aware that iron overload among dialysis patients is now an increasingly recognized clinical situation in the ESA era yet was previously considered rare. The KDIGO Controversies Conference on Iron Management in Chronic Kidney Disease, which took place in San Francisco on March 27 to 30, 2014, recognized the entity of iron overload in hemodialysis patients and called for an agenda of research on this topic, especially by means of magnetic resonance imaging (MRI).
It is therefore very likely that radiologists will be heavily solicited in the future by nephrology teams requesting quantitative hepatic MRI in dialysis patients, both for research purposes and for diagnosis and follow-up of iron overload. Radiologists should be aware of the marked differences in the pharmacological properties of available intravenous iron products and their potential interference with MRI. Specific MRI protocols need to be established in radiology divisions for each pharmaceutical iron product, especially for treated dialysis patients.
From the *Nephrology and Dialysis Unit and †Division of Radiology, Hôpital Privé Claude Galien, Générale de Santé, Quincy Sous Sénart, France.
Received for publication May 16, 2014; accepted July 24, 2014.
Reprints: Guy Rostoker, MD, PhD, Hôpital Privé Claude Galien, Générale de Santé, 20 route de Boussy, 91480 Quincy Sous Sénart, France (e-mail: email@example.com).
The authors report no conflicts of interest.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.