Is hepcidin-25 a clinically relevant parameter for the iron status in hemodialysis patients?
BACKGROUND
Accumulating data suggest potential clinical relevant relationships between hepcidin-25 levels, iron stores, erythropoiesis effectiveness, and epoetin dose. The immunometric methods and mass spectroscopy are currently used to measure hepcidin-25, but no standard exists, and values, although similar in trends, differ in absolute value.


OBJECTIVE
To investigate hepcidin levels and their relationship with peripheral iron indices, inflammation, and anemia therapy in patients on hemodialysis (HD).


METHODS
A cross-sectional study in 78 patients from a single HD center. Hepcidin-25 was measured with enzyme-linked immunosorbent assay (ELISA), using a commercial kit (Bachem, UK).


RESULTS
Hepcidin-25 levels were similar to those previously reported in studies using the same antibody (median 113 [95% CI; 107-122 ng/mL]) and significant but weak correlations of hepcidin with transferrin (R2=0.06; p<0.04) and ferritin (R2=0.09; p<0.01) were found. A model of multiple regression analysis explained 57% of variation along hepcidin quartiles. Lower hepcidin levels were associated with higher transferrin levels (odds ratio 1.05 [1.01-1.09]), bigger iron doses (odds ratio 1.09 [1.02-1.15]), and an increased darbepoetin resistance index (odds ratio 4.3E+15 [11.15-1.6E+30]). An elevated serum C reactive protein was associated with increased hepcidin levels (odds ratio 0.70 [0.49-0.99]), while a higher ultrafiltration volume (odds ratio 4.30 [1.28-14.51]) and the male sex (odds ratio 0.04 [0.00-0.80]) were related to lower hepcidin levels.


CONCLUSIONS
Cohort number and composition. Hepcidin-25 ELISA assay.


CONCLUSIONS
A low hepcidin level in hemodialysis patients with high epoetin resistance index could be a useful marker of iron-restricted erythropoiesis, but confirmation by a therapeutical trial is necessary.
Brătescu
Lavinia O
LO
International Healthcare Systems Sf. Pantelimon Dialysis Center, Bucharest, Romania.
Bârsan
Liliana
L
Munteanu
Dan
D
Stancu
Simona
S
Mircescu
Gabriel
G
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000188:drug therapy; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D000068256:Darbepoetin alfa; D004351:Drug Resistance; D004797:Enzyme-Linked Immunosorbent Assay; D004920:Erythropoiesis; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D064451:Hepcidins; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D007501:Iron / Q000008:administration & dosage; D000090463:Iron Deficiencies; D019190:Iron Overload / Q000097:blood*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014168:Transferrin / Q000032:analysis
D023181:Antimicrobial Cationic Peptides; D064451:Hepcidins; D014168:Transferrin; C545475:hepcidin 25, human; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D002097:C-Reactive Protein; D007501:Iron