title: Serum hepcidin levels in patients with end-stage renal disease on hemodialysis.
abstract: Patients on hemodialysis (HD) are usually anemic because of defective erythropoeisis. Hepcidin is a polypeptide that regulates iron homeostasis and could serve as an indicator of functional iron deficiency in patients with end-stage renal disease (ESRD); this may also aid in the assessment of patient's response to erythropoietin (EPO). The present study was directed to investigate serum levels of hepcidin, iron status and inflammation markers such as C-reactive protein (CRP) in patients with ESRD on maintenance HD and to observe the correlation of serum hepcidin with conventional iron and inflammatory markers. A total of 42 patients of both sexes on maintenance HD and EPO therapy were enrolled; 42 ageand sex-matched healthy subjects were included as controls. Laboratory tests including complete blood count, serum hepcidin, total iron binding capacity (TIBC), serum ferritin, serum iron and CRP were performed. Serum hepcidin levels were significantly higher in patients with ESRD than in the control group (18.2 ± 2.8 ng/mL and 8.5 ± 2.3 ng/mL, respectively P = 0.000). The hemoglobin, hematocrit, serum iron, TIBC and transferrin saturation levels in the patient group were significantly lower than in the control group. Higher hepcidin levels were found in EPO non-responders (19.6 ± 2.4 ng/mL) while lower levels (16.9 ± 2.5 ng/mL) were seen in responders (P = 0.001). A positive and significant correlation was observed between the values of serum hepcidin and CRP. Our study indicates that higher hepcidin levels are found in ESRD patients on HD and in those not responding to EPO. Our findings suggest that hepcidin might play a role in the pathophysiology of anemia associated with chronic diseases as well as EPO resistance.
authors.forename: Zille
authors.initials: Z
authors.lastname: Rubab
authors.forename: Huma
authors.initials: H
authors.lastname: Amin
authors.forename: Khizer
authors.initials: K
authors.lastname: Abbas
authors.forename: Shabbir
authors.initials: S
authors.lastname: Hussain
authors.forename: Muhammad Ikram
authors.initials: MI
authors.lastname: Ullah
authors.affiliation: Department of Hematology, University of Health Sciences, Lahore, Pakistan.
authors.forename: Shahida
authors.initials: S
authors.lastname: Mohsin
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014168:Transferrin / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D064451:Hepcidins; D014168:Transferrin; D004921:Erythropoietin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron