Influence of erythropoietin therapy on serum prohepcidin levels in dialysis patients.
BACKGROUND
Anemia is a common finding in dialysis patients. Recent evidence has accrued that hepcidin, an iron regulatory peptide, may play a crucial role in the pathophysiology of this condition. This study investigated the effect of erythropoietin (EPO) therapy on serum levels of prohepcidin, the pro-hormone of hepcidin, in patients with end-stage renal disease (ESRD) undergoing chronic dialysis treatment.


METHODS
A total of 40 ESRD patients with renal anemia receiving either hemodialysis or peritoneal dialysis were included in this study. The patients were randomly allocated to EPO (subcutaneous 2000 microg three times weekly) plus parenteral iron (n=23) or parental iron only (n=17). Serum prohepcidin levels were measured before and at the end of the study.


RESULTS
The two groups were comparable in their demographic and laboratory characteristics. No significant differences were found in hemoglobin, hematocrit, iron store indices, or serum levels of prohepcidin at study entry. Significant increases in both hemoglobin and hematocrit as well as a decrease in serum prohepcidin level were evident in the EPO group at the end of the 6-month follow-up in comparison with their values at study entry compared with the control group (P<0.01).


CONCLUSIONS
It is concluded that EPO therapy, besides enhancing erythropoiesis, modulates serum prohepcidin levels in dialysis patients.
Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey.
Mahmut
M
Arabul
Mustafa
M
Gullulu
Yusuf
Y
Yilmaz
Mehmet Ali
MA
Eren
Bulent
B
Baran
Cuma Bulent
CB
Gul
Guzin
G
Kocamaz
Kamil
K
Dilek
D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D064451:Hepcidins; D006801:Humans; D007263:Infusions, Parenteral; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013997:Time Factors
D023181:Antimicrobial Cationic Peptides; D064451:Hepcidins; D011498:Protein Precursors; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron