Abstract Background Iron overload by liver magnetic resonance imaging (MRI) is highly prevalent today in the hemodialysis population worldwide and is a controversial topic in the management of dialysis-related anemia, as iron deposits can be seen on MRI but without clinical consequences. The aim of this study was to look for evidence of pancreatic iron deposits (a surrogate marker of severity in iron overload diseases) and their possible association with mortality. Methods Liver iron concentration was analysed in 115 patients on dialysis using Signal-intensity MRI and R2* Relaxometry MRI to determine liver, spleen, spine, and pancreas iron loads. Results 44.3% (51/115) had liver iron overload upon MRI and 20% (23/115) of patients exhibited increased pancreatic iron load. The percentage of patients with abnormal pancreatic T2* was significantly higher in the group with moderate and severe liver iron overload (46.7% (7/15)) as compared to the groups of patients with normal iron load (15.6% (10/64)) and mild iron overload (16.7% (6/36)) (P = 0.032, Fisher’s exact test). Median survival time was reduced to 2.6 years in patients with pancreatic iron deposits as compared to 6.6 years in patients with normal pancreatic iron (P = 0.028, Log-rank test). Pancreatic iron deposits were associated with a threefold higher risk of death in the Cox proportional hazard regression model (hazard ratio: 3.614, P = 0.0031). Conclusion Pancreatic iron deposits are observed in a substantial proportion of patients on dialysis with moderate and severe liver iron overload and may be associated with an increased risk of mortality.
Rostoker et al. (Mon,) studied this question.