title: Serum hepcidin-25 and response to intravenous iron in patients with non-dialysis chronic kidney disease.
abstract: BACKGROUND
  Hepcidin-25 is an iron regulator which reduces iron absorption and promotes sequestration in the reticulo-endothelial system. We investigated hepcidin and traditional iron storage marker utility in predicting haemoglobin increment following bolus intravenous iron.
  
  
  METHODS
  The cohort included 129 consecutive non-dialysis chronic kidney disease patients that attended for intravenous iron over a 6-month period. Serum hepcidin-25 levels (determined by mass spectrometry) pre iron infusion and 6 weeks post were compared with ferritin and transferrin saturation in multivariate models.
  
  
  RESULTS
  Log10 ferritin [coefficient 0.559 (0.435-0.684) p < 0.001] and log10 high-sensitive C-reactive protein [coefficient 0.092 (0.000-0.184) p = 0.049] were significantly associated with baseline log10 hepcidin-25 levels. Log10 estimated glomerular filtration rate was the only independent determinant of pre-infusion haemoglobin [coefficient 1.37 (0.16-2.59) p = 0.027]. Log10 hepcidin-25 was an independent predictor of haemoglobin increment 6 weeks following iron infusion [coefficient -0.84 (-1.38 to -0.31) p = 0.002]. Ferritin, transferrin saturation and hepcidin had similar predictive utility for a 1 g/dl haemoglobin increase (c-statistics: 0.68, 0.70, 0.69).
  
  
  CONCLUSIONS
  Hepcidin is an iron sensor marker which predicts the magnitude of haemoglobin increment following protocolised intravenous iron infusion. Although displaying similar predictive performance to ferritin and transferrin saturation, hepcidin may also play a mechanistic role.
authors.affiliation: Renal Department, First Floor, Centre for Translational Inflammation Research, Queen Elizabeth Hospital Birmingham, University of Birmingham, Birmingham, B15 2WB, UK, sourabh.chand@nhs.net.
authors.forename: Sourabh
authors.initials: S
authors.lastname: Chand
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Ward
authors.forename: Zhi-Yan Valerie
authors.initials: ZY
authors.lastname: Ng
authors.forename: James
authors.initials: J
authors.lastname: Hodson
authors.forename: Heidi
authors.initials: H
authors.lastname: Kirby
authors.forename: Patricia
authors.initials: P
authors.lastname: Steele
authors.forename: Irina
authors.initials: I
authors.lastname: Rooplal
authors.forename: Ferly
authors.initials: F
authors.lastname: Bantugon
authors.forename: Tariq
authors.initials: T
authors.lastname: Iqbal
authors.forename: Chris
authors.initials: C
authors.lastname: Tselepis
authors.forename: Mark T
authors.initials: MT
authors.lastname: Drayson
authors.forename: Alison
authors.initials: A
authors.lastname: Whitelegg
authors.forename: Marie
authors.initials: M
authors.lastname: Chowrimootoo
authors.forename: Richard
authors.initials: R
authors.lastname: Borrows
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000378:metabolism*; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D014168:Transferrin / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D064451:Hepcidins; D014168:Transferrin; C545475:hepcidin 25, human; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron