title: Serum hepcidin-25 levels predict the progression of renal anemia in patients with non-dialysis chronic kidney disease.
abstract: BACKGROUND
  Hepcidin is associated with iron-restricted erythropoiesis. A previous cross-sectional study showed that serum hepcidin-25 levels are negatively associated with the hemoglobin concentration in non-dialysis chronic kidney disease (CKD) patients with sufficient iron stores. This longitudinal study aimed at ascertaining the association between hepcidin-25 levels and the progression of renal anemia.
  
  
  METHODS
  We selected 335 non-dialysis CKD patients who showed hemoglobin concentrations >10 g/dL and who were not receiving erythropoiesis-stimulating agent (ESA) therapy, from among the subjects of our previous study, who had been recruited between February and June 2007 in a previous study. The primary outcome was the start of the ESA therapy or hemoglobin concentrations remaining below 10 g/dL for >3 months, by 31 December 2010. The patients were classified into high- and low-ferritin groups depending on their median ferritin levels. The Cox proportional hazard model with restricted cubic spline curve analysis was used to determine the association between hepcidin-25 levels and the outcome for each group.
  
  
  RESULTS
  The hepcidin-25 level was a significant predictor both for the high-ferritin group (P = 0.04, linearity = 0.02) and for the low-ferritin group (P = 0.04, linearity P = 0.02). The spline curve for the high-ferritin group showed that higher hepcidin-25 levels had a high log-relative hazard.
  
  
  CONCLUSIONS
  Higher hepcidin-25 levels predict the progression of anemia in non-dialysis CKD patients with sufficient iron stores, indicating the involvement of hepcidin in the progression of anemia in non-dialysis CKD patients.
authors: Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan. kakuya_niihata@hotmail.com
authors: Kakuya
authors: K
authors: Niihata
authors: Naohisa
authors: N
authors: Tomosugi
authors: Takuya
authors: T
authors: Uehata
authors: Tatsuya
authors: T
authors: Shoji
authors: Kensuke
authors: K
authors: Mitsumoto
authors: Morihiro
authors: M
authors: Shimizu
authors: Hiroaki
authors: H
authors: Kawabata
authors: Yusuke
authors: Y
authors: Sakaguchi
authors: Akira
authors: A
authors: Suzuki
authors: Terumasa
authors: T
authors: Hayashi
authors: Noriyuki
authors: N
authors: Okada
authors: Yoshitaka
authors: Y
authors: Isaka
authors: Hiromi
authors: H
authors: Rakugi
authors: Yoshiharu
authors: Y
authors: Tsubakihara
mesh_terms: D000740:Anemia / Q000097:blood* / Q000209:etiology*; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D064451:Hepcidins; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D023181:Antimicrobial Cationic Peptides; D064451:Hepcidins; C545475:hepcidin 25, human