Is hepcidin a link between anemia, inflammation and liver function in hemodialyzed patients?
BACKGROUND
Hepcidin synthesis in hepatocytes is modulated in response to anemia, hypoxia or inflammation. A cross-sectional study was performed to assess hepcidin correlations with markers of iron status, erythropoietin therapy and markers of inflammation in hemodialyzed patients and in the healthy volunteers.


METHODS
Iron status, complete blood count, creatinine, albumin, lipids were assessed using standard laboratory methods. Hepcidin and high-sensitivity CRP were measured using commercially available kits.


RESULTS
Serum iron, TIBC, TSAT, erythrocyte count, Hb, Ht, platelet count, albumin, and cholesterol were lower, whereas ferritin and hepcidin were higher in hemodialyzed patients over controls. Hepcidin correlated positively with triglycerides, albumin, aspartate aminotransferase, lymphocyte count, ferritin and erythropoietin dose and negatively with erythrocyte count, Hb, and Ht in hemodialyzed patients. In multiple regression analysis, triglycerides (beta value was 0.28, p = 0.02) and albumin (beta value was -0.31, p = 0.006) were correlates of hepcidin in hemodialyzed patients.


CONCLUSIONS
Elevated hepcidin levels in hemodialyzed patients may be due to functional iron deficiency and anemia. Liver plays an important role in the synthesis of hepcidin. Low-grade inflammation, frequently found in hemodialyzed patients, might also contribute to elevated hepcidin concentration. Hypothesis that hepcidin might link anemia, inflammation and liver function in kidney disease should be further evaluated.
Małyszko
Jolanta
J
Department of Nephrology and Transplantology, Medical University, Białystok, Poland. jolmal@pcozta.onet.pl
Małyszko
Jacek S
JS
Hryszko
Tomasz
T
Pawlak
Krystyna
K
Mysliwiec
Michał
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000188:drug therapy; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D064451:Hepcidins; D006801:Humans; D007249:Inflammation / Q000097:blood; D007501:Iron / Q000097:blood / Q000627:therapeutic use; D007668:Kidney / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood*; D008099:Liver / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D064451:Hepcidins; D004921:Erythropoietin; D007501:Iron