title: Intra-individual variability in serum hepcidin precludes its use as a marker of iron status in hemodialysis patients.
abstract: An accurate assessment of iron status in dialysis patients is important because both anemia and overtreatment with erythropoiesis-stimulating agents are associated with poor clinical outcomes. We have previously shown that both analytical and intra-individual (biological) variability in serum ferritin limits its utility as a proxy for iron stores in patients in this setting. As hepcidin is a direct regulator of iron status, its measurement might be useful for monitoring patients with iron dysregulation. We assessed short-term intra-individual variation of serum hepcidin in 28 patients with stable chronic kidney disease on hemodialysis. The intra-individual variability for serum hepcidin ranged from 9-79% during an initial 2-week to 12-85% over a 6-week period. The concentration of serum hepcidin was significantly correlated with serum C-reactive protein levels over the 6-week study period. Hence, significant intra-individual variability of hepcidin is likely dependent on short-term fluctuations in the inflammatory state. Thus, our results suggest that short-term measurement of serum hepcidin should not be used to guide clinical decisions regarding management of iron status in chronic hemodialysis patients.
authors.affiliation: Department of Pathology and Immunology, Washington University, St Louis, Missouri 63110, USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Ford
authors.forename: Charles S
authors.initials: CS
authors.lastname: Eby
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Scott
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Coyne
mesh_terms: D000368:Aged; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005293:Ferritins / Q000097:blood; D064451:Hepcidins; D006801:Humans; D007249:Inflammation; D007501:Iron / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron