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Study of hepcidin level in patients with chronic kidney disease and its correlation with markers of iron status in Zagazig University Hospital
The Egyptian Journal of Internal Medicine volume 30, pages 284–288 (2018)
Abstract
Context
Chronic kidney disease (CKD) including hemodialysis (HD) is considered an inflammatory state leading to hepcidin upregulation, which affects iron homeostasis.
Aims
The aim was to assess the serum level of hepcidin in CKD including HD patients and its correlation with markers of iron status.
Settings and design
The study was conducted in Zagazig University hospital.
Participants and methods
A prospective, case–control, comparative study was conducted on 66 participants, who were divided into control group, comprising 22 healthy participants; HD group, comprising 22 patients; and CKD group, comprising 22 patients from stages 2 to 4. All participants were evaluated for serum creatinine, complete blood count, estimated glomerular filtration rate by MDRD4 equation, serum iron, total iron-binding capacity, serum ferritin, transferrin saturation, C-reactive protein, and serum hepcidin level.
Statistical analysis
The study was analyzed using SPSS version 20. Description of the qualitative variables was done by frequency and percentage. Description of the quantitative variables was in the form of mean and SD. χ2 -Test, Student’s t-test, analysis of variance (F-test), and correlation analysis were used for analyzing the data.
Results
Serum level of hepcidin was increase by increase stages of CKD, and more increase in regular HD patients. There was high statistically significant positive correlation of hepcidin level with serum ferritin (P<0.001), serum iron (P<0.05) in CKD and negative correlation with Hb, eGFR (P<0.001), and it was not correlated with total iron binding capacity (TIBC) (P<0.48).
Conclusion
Serum hepcidin levels are a good biomarker for iron status in patients with HD and CKD. In addition, determination of hepcidin together with markers associated with iron metabolism improves the identification of patients with iron deficiency.
References
Tsubakihara Y, Nishi S, Akiba T, Hirakata H, Iseki K, Kubota M, et al. 2008 Japanese Society for Dialysis Therapy: guidelines for renal anemia in chronic kidney disease. Ther Apher Dial 2010; 14:240–275.
Uehata T, Tomosugi N, Shoji T, Sakaguchi Y, Suzuki A, Kaneko T, et al. Serum hepcidin-25 levels and anemia in non-dialysis chronic kidney disease patients: a cross-sectional study. Nephrol Dial Transplant 2012; 27:1076–1083.
Ford BA, Eby CS, Scott MG, Coyne DW. Intra-individual variability in serum hepcidin precludes its use as a marker of iron status in hemodialysis patients. Kidney Int 2010; 78:769–773.
Zaritsky J, Young B, Wang HJ, Westerman M, Olbina G, Nemeth E, et al. Hepcidin – a potential novel biomarker for iron status in chronic kidney disease. Clin J Am Soc Nephrol 2009; 4:1051–1056.
Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim Care 2008; 35:329–344.
Zarychanski R, Houston DS. Anaemia of chronic disease: a harmful disorder or an adaptive, beneficial response?.. CMAJ 2008; 179:333–337.
Sanad M, Gharib AF. Urinary hepcidin level as an early predictor of iron deficiency in children: a case control study. Ital J Pediatr 2011; 37:37.
Omena J, Cople-Rodrigues DSC, Dias do A, Cardoso MJ, Sares RA, Fleury KM, et al. Serum hepcidin concentration in individuals with sickle cell anemia: basis for the dietary recommendation of iron. Nutrients 2018; 10:498.
Peters HP, Laarakkers CM, Swinkels DW, Wetzels JF. Serum hepcidin-25 levels in patients with chronic kidney disease are independent of glomerular filtration rate. Nephrol Dial Transplant 2009; 25:848–853.
Jairam A, Das R, Aggarwal PK, Kohli HS, Gupta KL, Sakhuja V, et al. Iron status, inflammation and hepcidin in ESRD patients: The confounding role of intravenous iron therapy. Indian J Nephrol 2010; 20:125.
Swinkels DW, Wetzels JF. Hepcidin: a new tool in the management of anaemia in patients with chronic kidney disease?. Nephrol Dial Transplant 2008; 23:2450–2453.
Xu Y, Ding XQ, Zou JZ, Liu ZH, Jiang SH, Chen YM. Serum hepcidin in haemodialysis patients: associations with iron status and microinflammation. J Int Med Res 2011; 39:1961–1967.
Wish JB. Assessing iron status: beyond serum ferritin and transferrin saturation. Clin J Am Soc Nephrol 2006; 1(Suppl 1):S4–S8.
Singh B, Arora S,Agrawal P, Gupta SK. Hepcidin: a novel peptide hormone regulating iron metabolism. Clinica Chimica Acta 2011; 412:823–830.
Pasricha SR, McQuilten Z, Westerman M, Keller A, Nemeth E, Ganz T, et al. Serum hepcidin as a diagnostic test of iron deficiency in premenopausal female blood donors. Haematologica 2011; 96:1099–1105.
Sancho A, Pastor MC, Troya M, Bonal J, Bayés B, Morales-Indiano C, et al. Hepcidin and iron deficiency in pre-kidney transplant patients. Transplant Proc 2009; 41:2079–2081.
Atkinson MA, Kim JY, Roy CN, Warady BA, White CT, Furth SL. Hepcidin and risk of anaemia in CKD: a cross-sectional and longitudinal analysis in the CKiD cohort. Pediatr Nephrol 2015; 30:635–643.
Goyal H, Mohanty S, Sharma M, Rani A. Study of anaemia in nondialysis dependent chronic kidney disease with special reference to serum hepcidin. Indian J Nephrol 2017; 27:44.
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Kamal, N.M., Diab, M. & Khalil, R.A. Study of hepcidin level in patients with chronic kidney disease and its correlation with markers of iron status in Zagazig University Hospital. Egypt J Intern Med 30, 284–288 (2018). https://doi.org/10.4103/ejim.ejim_31_18
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DOI: https://doi.org/10.4103/ejim.ejim_31_18