title: Increased hepcidin-25 and erythropoietin responsiveness in patients with cardio-renal anemia syndrome.
abstract: Hepcidin is a key regulator controlling iron intestinal absorption and distribution through the body. The article by van der Putten et al. examined the association between hepcidin-25 and erythropoietin responsiveness and inflammation in erythropoietin-naive, iron-replete patients with chronic heart failure and chronic kidney disease. A cross-sectional observation revealed that serum hepcidin-25 was elevated almost twofold when compared with levels in healthy subjects. Hepcidin-25 was inversely correlated with hemoglobin (r(2) = 0.18; p < 0.02), and positively with ferritin (r(2) = 0.51; p < 0.01) and transferrin saturation (r(2) = 0.14; p < 0.03), while it did not correlate with levels of IL-6 and highly sensitive C-reactive protein. They found that 2-week erythropoietin therapy (50 IU/kg/week) significantly decreased hepcidin-25 levels. The magnitude of the decrease in hepcidin-25 levels correlated with the increase in reticulocytes (r(2) = 0.23; p < 0.03) and soluble transferrin receptor (r(2) = 0.23; p = 0.03), but not with inflammatory markers. A decline in hepcidin-25 correlated with the increment of hemoglobin after 6 months (r(2) = 0.49; p < 0.01). The findings convincingly suggest that hepcidin-25 may be useful in predicting erythropoietin responsiveness in stable chronic heart failure patients. However, further studies will be needed to establish clinically available methods to reliably measure hepcidin-25 level.
authors.affiliation: Division of Blood Purification, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Shizuoka, Japan. a.kato@hama-med.ac.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kato
mesh_terms: D000740:Anemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D023181:Antimicrobial Cationic Peptides / Q000097:blood / Q000502:physiology*; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D055316:Cystatin C / Q000378:metabolism; D004921:Erythropoietin / Q000378:metabolism / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood*; D064451:Hepcidins; D006801:Humans; D007501:Iron / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008403:Mass Screening; D011994:Recombinant Proteins; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D055316:Cystatin C; D064451:Hepcidins; D011994:Recombinant Proteins; C545475:hepcidin 25, human; D004921:Erythropoietin; D002097:C-Reactive Protein; D007501:Iron