Date Published: 
Monday, 15 December, 2014

New clinical protocols are required to avoid MRI interference in dialysis patients treated with iron therapy, article highlights

Researchers have revealed that dialysis patients receiving iron therapy may require washout periods prior to undergoing magnetic resonance imaging (MRI), to ensure interference is avoided, and accurate readings are obtained. The washout period is dependent on the specific iron treatment used.

The clinical management approaches for anaemia in dialysis patients have changed markedly over the past 10 years. Clinicians are prescribing fewer erythropoiesis-stimulating agents (ESAs) and more intravenous iron therapy, due to safety concerns surrounding ESA use. However, excessive iron therapy has the potential to lead to iron overload, which, if left untreated, can cause organ damage.

Iron status can be assessed non-invasively through MRI; a method of assessment which has been widely integrated into the standard of care. However, a recent study has reported that intravenous ferumoxytol can cause interference with MRI assessments, for up to 6 months post-treatment1.  Intravenous iron sucrose has also been shown to cause interference, although further studies have demonstrated that only a 7-day washout period is required to avoid inaccurate MRI readings2.

The authors conclude that radiologists must be aware of the differences in the pharmacological properties of available intravenous iron therapies and of their potential to interfere with MRI assessments. They state that there is a need for specific MRI protocols to be established for each iron therapy formulation, in order to ensure accurate assessments of iron status and avoid unnecessary iron overload in dialysis patients.

The full article is available in the September 2014 issue of Journal of computer assisted tomography. For information on iron deficiency in nephrology, please click here.