SUMMARYAtherosclerosis is a disease of the arterial wall, with increasing wall thickness representing an early event in the progression of the disease. It has been suggested that iron overload, as assessed by increased serum ferritin concentration, may be a risk factor for atherosclerosis.The aim of this study was to investigate the relationship between the influence of intravenous (IV) iron therapy and ferritin levels and carotid intima media thickness (C-IMT) in dialysis patients. Sixty patients (51 ± 14) years were divided into two groups according to their IMT obtained by ultrasound; group I (high risk) and group II (low risk). The parameters assessed were serum creatinine, urea, calcium, phosphorus, hemoglobin, albumin, uric acid, iron, ferritin, and lipid levels. Thirty-eight patients (88%) in group I and 5 patients (12%) in group II received IV iron therapy while 5 patients (29%) in group I and 12 patients (71%) in group II (P < 0.001) did not receive IV iron therapy. Ferritin levels were higher in group I than in group II (581 ± 303 and 306 ± 224) (P < 0.001). C-IMT measurements correlated with serum ferritin and with the intravenous iron dose received during the 24 months preceding the study (r = 0.315, P = 0.015; r = 0.471, P = 0.001).The findings indicate that IV iron therapy and elevated serum ferritin levels may cause an increase in the incidence of atherosclerosis. (Int Heart J 2005; 46: 255-264)

The aim of this study is to evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), and retinal nerve fiber layer thickness (RNFLT) in patients with chronic renal failure undergoing hemodialysis (HD). A complete ophthalmological examination together with IOP, CCT, and RNFLT measurements were performed for each patient both before and after HD sessions. RNFLT parameters were detected by scanning laser polarimeter. Total body weight and serum osmolality were also measured. Only the left eyes were recruited for statistical analysis. Thirty-three eyes of 33 patients were enrolled in the study. Mean IOP decreased from 14.7 +/- 3.1 to 13.4 +/- 2.4 mmHg after HD (paired t test, P = 0.005). Mean CCT also decreased significantly after HD, from 556.5 +/- 33.5 to 550.2 +/- 34.6 mum (paired t test, P = 0.002). CCT change in the left eyes was found to be correlated with total body volume loss (Pearson correlation test, R = 0.391 and P = 0.030). Considering RNFLT parameters before and after HD, no significant alterations were detected by scanning laser polarimeter (paired t test, P > 0.05). We conclude that IOP may decrease to some extent after HD. CCT may be affected by fluid loss after HD sessions, with a resultant decrease in corneal thickness. In patients with chronic renal failure undergoing HD, RNFLT parameters can be measured as in healthy individuals. Underestimation of intraocular pressure values after HD sessions should be taken into account, especially in patients with chronic renal failure.

Dry eye and irritational symptoms are major ocular symptoms in CRF patients. Serum calcium and phosphate levels seem to have a prognostic importance for the ocular findings and symptoms in patients with CRF.

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