Abstract
Iron therapy or blood transfusion is genemally used to treat anemia in chronic hemodialysis patients, but the recognition of hemosiderosis has been very difficult. Serum ferritin is now widely used to diagnose hemosiderosis, but CT is considered to be more efficient for this purpose. With this in mind, we examined 25 hemodialysis patients receiving parenteral iron therapy or blood transfusions. The correlation between serum ferritin levels and total iron loads (g.) is weak (r=0.491, p<0.02), but that with liver CT numbers (H. U.) is highly significant (r=0.714, p<0.001). Transient elevation of transaminases was observed in 10 patients when iron was administered. Transaminase values correlated well to total iron load and liver CT numbers, but only weakly to serum ferritin levels. In all patients whose liver CT numbers exceeded 80 H. U. transaminases were found to be elevated. Spleen CT numbers indicating function of the reticuloendothelial system in that organ rose as well, but less than liver CT numbers. Liver CT number also increased with the volume of blood transfusions. CT examined six months later showed few changes in liver CT numbers suggesting irreversible liver iron deposition. It may be concluded that CT is the best method to detect early hemosiderosis, and even if iron therapy or blood transfusion is needed, it is desirable to examine liver CT occasionally in order to keep the CT number at less than 80 H. U.
