{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T04:46:51Z","timestamp":1762663611125,"version":"build-2065373602"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ramsay Health Cooperation Group for Education and Research","award":["COS-RGDS-2018-12-013"],"award-info":[{"award-number":["COS-RGDS-2018-12-013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Liver iron concentration was analyzed in 115 patients on dialysis using signal intensity ratio MRI and R2* Relaxometry MRI to determine liver, spleen, spine and pancreas iron loads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 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 with the groups of patients with normal iron load [15.6% (10\/64)] and mild iron overload [16.7% (6\/36)] (P\u00a0=\u00a0.032, Fisher\u2019s exact test). Median survival time was reduced to 2.6 years in patients with pancreatic iron deposits as compared with 6.6 years in patients with normal pancreatic iron (P\u00a0=\u00a0.028, Log-rank test). Pancreatic iron deposits were associated with a 3-fold higher risk of death in the Cox proportional hazard regression model (hazard ratio 3.614, P\u00a0=\u00a0.0031).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                    <jats:p>Trial registration: ClinicalTrials.gov number NCT05593068.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf309","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:53:38Z","timestamp":1759492418000},"source":"Crossref","is-referenced-by-count":0,"title":["Evidence of pancreatic iron deposits and their association with mortality in dialysis-associated iatrogenic hemosiderosis"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4383-3825","authenticated-orcid":false,"given":"Guy","family":"Rostoker","sequence":"first","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Nephrology and Dialysis, , Quincy-sous-S\u00e9nart ,","place":["France"]},{"name":"Coll\u00e8ge de M\u00e9decine des H\u00f4pitaux de Paris , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireille","family":"Griuncelli","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Nephrology and Dialysis, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Francisco","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Radiology, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christelle","family":"Loridon","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Nephrology and Dialysis, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Languille-Llitjos","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Nephrology and Dialysis, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghada","family":"Boulahia","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Nephrology and Dialysis, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Cohen","sequence":"additional","affiliation":[{"name":"Ramsay Health Care, Claude Galien Private Hospital Department of Radiology, , Quincy-sous-S\u00e9nart ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"2025110823452045100_bib1","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1681\/ASN.2006080856","article-title":"Clinical aspects of iron use in the anemia of kidney disease","volume":"18","author":"H\u00f6rl","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2025110823452045100_bib2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.2215\/CJN.04190510","article-title":"Serum iron markers are inadequate for guiding iron repletion in chronic kidney disease","volume":"6","author":"Ferrari","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025110823452045100_bib3","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/j.1600-0609.2012.01783.x","article-title":"Evidence for tissue iron overload in long-term hemodialysis patients and the impact of withdrawing parenteral iron","volume":"89","author":"Ghoti","year":"2012","journal-title":"Eur J Haematol"},{"key":"2025110823452045100_bib4","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.amjmed.2012.01.015","article-title":"Hemodialysis-associated hemosiderosis in the era of erythropoiesis-stimulating agents: a MRI study","volume":"125","author":"Rostoker","year":"2012","journal-title":"Am J Med"},{"key":"2025110823452045100_bib5","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/hdi.13054","article-title":"Hepatic and cardiac iron overload quantified by magnetic resonance imaging in patients on hemodialysis: a systematic review and meta-analysis","volume":"27","author":"Nashwan","year":"2023","journal-title":"Hemodial Int"},{"key":"2025110823452045100_bib6","doi-asserted-by":"publisher","first-page":"3062","DOI":"10.1093\/ndt\/gfs488","article-title":"Hepcidin-25 is related to cardiovascular events in chronic haemodialysis patients","volume":"28","author":"Van der Weerd","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"2025110823452045100_bib7","first-page":"e87091","article-title":"Effect of serum hepcidin on predicting mortality in hemodialysis patients: a prospective cohort study","volume":"21","author":"Sun","year":"2019","journal-title":"Iran Red Crescent Med J"},{"key":"2025110823452045100_bib8","doi-asserted-by":"publisher","first-page":"e0306255","DOI":"10.1371\/journal.pone.0306255","article-title":"High ferritin is associated with liver and bone marrow iron accumulation: effects of 1-year deferoxamine treatment in hemodialysis-associated iron overload","volume":"19","author":"Nunes","year":"2024","journal-title":"PLoS One"},{"key":"2025110823452045100_bib9","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/hdi.13081","article-title":"Hemosiderosis in chronic dialysis patients: monitoring the response to deferasirox by quantitative hepatic magnetic resonance imaging","volume":"27","author":"Bekhechi","year":"2023","journal-title":"Hemodial Int"},{"key":"2025110823452045100_bib10","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.kint.2015.10.002","article-title":"Iron management in chronic kidney disease: conclusions from a \u201cKidney Disease: Improving Global Outcomes\u201d (KDIGO) Controversies Conference","volume":"89","author":"Macdougall","year":"2016","journal-title":"Kidney Int"},{"key":"2025110823452045100_bib11","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511777035","volume-title":"Handbook of Iron Overload Disorders","author":"Barton","year":"2010"},{"key":"2025110823452045100_bib12","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1016\/j.lpm.2017.10.007","article-title":"Iron overload in hematological disorders","volume":"46","author":"Fibach","year":"2017","journal-title":"Presse Med"},{"key":"2025110823452045100_bib13","doi-asserted-by":"publisher","first-page":"4021","DOI":"10.1182\/blood-2009-06-225615","article-title":"Pancreatic iron loading predicts cardiac iron loading in thalassemia major","volume":"114","author":"Noetzli","year":"2009","journal-title":"Blood"},{"key":"2025110823452045100_bib14","doi-asserted-by":"publisher","first-page":"6015","DOI":"10.3390\/jcm12186015","article-title":"Pancreatic T2* magnetic resonance imaging for prediction of cardiac arrhythmias in transfusion-dependent thalassemia","volume":"12","author":"Meloni","year":"2023","journal-title":"J Clin Med"},{"key":"2025110823452045100_bib15","doi-asserted-by":"publisher","first-page":"e30923","DOI":"10.1002\/pbc.30923","article-title":"Pancreatic iron in pediatric transfusion-dependent beta-thalassemia patients: a longitudinal MRI study","volume":"71","author":"Meloni","year":"2024","journal-title":"Pediatr Blood Cancer"},{"key":"2025110823452045100_bib16","doi-asserted-by":"publisher","DOI":"10.1186\/ISRCTN80100088","article-title":"ISRCTN80100088: a cohort study of haemodialysis patients based on hepatic magnetic resonance imaging","author":"ISRCTN Registry","year":"2024"},{"key":"2025110823452045100_bib17","doi-asserted-by":"publisher","first-page":"104929","DOI":"10.1016\/j.ebiom.2023.104929","article-title":"Relationship between bone marrow iron load and liver iron concentration in dialysis-associated haemosiderosis","volume":"99","author":"Rostoker","year":"2024","journal-title":"EBioMedicine"},{"key":"2025110823452045100_bib18","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/S0140-6736(04)15436-6","article-title":"Non-invasive assessment of hepatic iron stores by MRI","volume":"363","author":"Gandon","year":"2004","journal-title":"Lancet"},{"key":"2025110823452045100_bib19","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1182\/blood-2004-10-3982","article-title":"MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients","volume":"106","author":"Wood","year":"2005","journal-title":"Blood"},{"key":"2025110823452045100_bib20","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1097\/RLI.0b013e3181862413","article-title":"T2* relaxometry in liver, pancreas, and spleen in a healthy cohort of one hundred twenty-nine subjects-correlation with age, gender, and serum ferritin","volume":"43","author":"Schwenzer","year":"2008","journal-title":"Invest Radiol"},{"key":"2025110823452045100_bib21","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1002\/jmri.21707","article-title":"Assessment of iron distribution between liver, spleen, pancreas, bone marrow, and myocardium by means of R2 relaxometry with MRI in patients with beta-thalassemia major","volume":"29","author":"Papakonstantinou","year":"2009","journal-title":"Magn Reson Imaging"},{"key":"2025110823452045100_bib22","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1111\/bjh.14915","article-title":"Iron storage in liver, bone marrow and splenic Gaucheroma reflects residual disease in type 1 Gaucher disease patients on treatment","volume":"179","author":"Regenboog","year":"2017","journal-title":"Br J Haematol"},{"key":"2025110823452045100_bib23","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1002\/mrm.22640","article-title":"Regional and global pancreatic T2* MRI for iron overload assessment in a large cohort of healthy subjects: normal values and correlation with age and gender","volume":"65","author":"Restaino","year":"2011","journal-title":"Magn Reson Med"},{"key":"2025110823452045100_bib24","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1093\/ndt\/gfn653","article-title":"Anaemia management in patients with chronic kidney disease: a position statement by th Anaemia Working Group of European Renal Best Practice (ERBP)","volume":"24","author":"Locatelli","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"2025110823452045100_bib25","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1093\/ndt\/gft033","article-title":"Kidney Disease: Improving Global Outcomes guidelines on anaemia management in chronic kidney disease: a European Renal Best Practice position statement","volume":"28","author":"Locatelli","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"2025110823452045100_bib26","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1186\/s12882-022-03020-1","article-title":"Prognostic value of the combination of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio and platelet-to-lymphocyte ratio on mortality in patients on maintenance hemodialysis","volume":"23","author":"Liao","year":"2022","journal-title":"BMC Nephrol"},{"key":"2025110823452045100_bib27","doi-asserted-by":"publisher","first-page":"5452","DOI":"10.3390\/jcm12175452","article-title":"Neutrophil-to-lymphocyte ratio, neutrophil-to-monocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index in psoriasis patients: response to treatment with biological drugs","volume":"12","author":"Albayrak","year":"2023","journal-title":"J Clin Med"},{"key":"2025110823452045100_bib28","volume-title":"Handbook of Parametric and Nonparametric Statistical Procedures","author":"Sheskin","year":"2007","edition":"4th edn"},{"key":"2025110823452045100_bib29","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12979-018-0121-z","article-title":"ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications","volume":"15","author":"Ducloux","year":"2018","journal-title":"Immun Ageing"},{"key":"2025110823452045100_bib30","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1159\/000486968","article-title":"Positive iron balance in chronic kidney disease: how much is too much and how to tell?","volume":"47","author":"Wish","year":"2018","journal-title":"Am J Nephrol"},{"key":"2025110823452045100_bib31","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.1093\/ndt\/gft062","article-title":"Variation in intravenous use internationally and over time: the Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"28","author":"Bailie","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"2025110823452045100_bib32","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1093\/ckj\/sfac245","article-title":"Management of anaemia in French dialysis patients: results from a large epidemiological retrospective study","volume":"16","author":"Zaoui","year":"2023","journal-title":"Clin Kidney J"},{"key":"2025110823452045100_bib33","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/j.clinthera.2014.01.015","article-title":"Anemia management tends in hospital-based dialysis centers (HBDCs), 2010 to 2013","volume":"36","author":"Coritsidis","year":"2014","journal-title":"Clin Ther"},{"key":"2025110823452045100_bib34","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.2215\/CJN.02600315","article-title":"Understanding the recent increase in ferritin levels in United States dialysis patients: potential impact of changes in intravenous iron and erythropoiesis-stimulating agent dosing","volume":"10","author":"Karaboyas","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025110823452045100_bib35","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.nephro.2015.04.009","article-title":"Use of intravenous iron supplementation in chronic kidney disease: interests, limits, and recommendations for a better practice","volume":"11","author":"Rottembourg","year":"2015","journal-title":"Nephrol Ther"},{"key":"2025110823452045100_bib36","doi-asserted-by":"publisher","first-page":"865669","DOI":"10.3389\/fmed.2022.865669","article-title":"Iron overload in chronic kidney disease: less ferritin, more T2* MRI","volume":"9","author":"Nashwan","year":"2022","journal-title":"Front Med"},{"key":"2025110823452045100_bib37","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.3390\/pharmaceutics14071408","article-title":"Differential pharmacokinetics of liver tropism for iron sucrose, ferric carboxymaltose, and iron isomaltoside: a clue to their safety for dialysis patients","volume":"14","author":"Rostoker","year":"2022","journal-title":"Pharmaceutics"},{"key":"2025110823452045100_bib38","doi-asserted-by":"publisher","first-page":"5284","DOI":"10.3390\/jcm11185284","article-title":"Efficacy, safety and pharmacoeconomic analysis of intravenous ferric carboxymaltose in anemic hemodialysis patients unresponsive to ferric gluconate treatment: a multicenter retrospective study","volume":"11","author":"Rosati","year":"2022","journal-title":"J Clin Med"},{"key":"2025110823452045100_bib39","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12882-025-04115-1","article-title":"UK kidney association clinical practice guideline : update of anaemia of chronic kidney disease","volume":"26","author":"Bhandari","year":"2025","journal-title":"BMC Nephrol"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfaf309\/64518892\/sfaf309.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/11\/sfaf309\/64518892\/sfaf309.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/11\/sfaf309\/64518892\/sfaf309.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T04:45:27Z","timestamp":1762663527000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/doi\/10.1093\/ckj\/sfaf309\/8275751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":39,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfaf309","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"type":"print","value":"2048-8505"},{"type":"electronic","value":"2048-8513"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,10,6]]},"article-number":"sfaf309"}}