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Abstract
Background
Hepcidin, a key regulator of iron homeostasis, is associated with iron metabolism imbalance in patients with chronic kidney disease (CKD). However, serum hepcidin level in anemic patients with CKD presents a contradictory picture. We investigated the relationship between serum hepcidin-25 level and iron parameters in patients with CKD.
Methods
We defined and categorized patients with CKD according to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. We analyzed the relationship between serum hepcidin-25 level and iron parameters [serum iron, total iron-binding capacity (TIBC), unbound iron-binding capacity (UIBC), transferrin saturation, and ferritin levels] according to the CKD stage and clinical and laboratory characteristics.
Results
Hb level, TIBC, and UIBC decreased and ferritin level increased (Ptrend<0.001) (stage 1-2, 28; stage 3, 40; stage 4, 36; stage 5, 42) as the CKD stage progressed. Serum hepcidin-25 level showed no significant trend with the progressing CKD stage [stage 1-2, 13.7 (3.7-25.0) ng/mL; stage 3, 14.0 (0.8-26.5) ng/mL; stage 4, 13.9 (2.0-32.1) ng/mL; stage 5, 13.8 (0.5-42.4) ng/mL; Ptrend=0.618]. No significant relationship was noted between serum hepcidin-25 level and kidney function parameters, Hb levels, or iron parameters (P>0.05).
Conclusions
Serum hepcidin-25 level was not found to be associated with iron parameters or clinical status of CKD patients in our study. Determination of hepcidin-25 levels may not provide more information than conventional iron parameters in monitoring iron metabolism in CKD patients. However, further studies are needed to establish the clinical utility of hepcidin measurement in CKD patients.
Figures and Tables
Fig. 1
Levels of serum hepcidin-25 in patients with chronic kidney disease and control population. CKD, chronic kidney disease.
Fig. 2
Relationship between the levels of serum hepcidin-25 and creatinine (A), eGFR (B), hemoglobin (C), iron (D), transferrin saturation (E), and ferritin (F) in patients with chronic kidney disease.
Table 1
Clinical and laboratory characteristics of 146 patients with chronic kidney disease
Abbreviations: CKD, chronic kidney disease; GN, glomerulonephritis; ESA, erythropoiesis stimulating agent; ACE, angiotensin converting enzyme; ARB, angiotensin receptor blocker; BUN, blood urea nitrogen; Cr, creatinine; eGFR, estimated glomerular filtration rate; Hb, hemoglobin; TIBC, total iron binding capacity; UIBC, unsaturated iron binding capacity; TSAT, transferrin saturation; N/A, not applicable.
Table 2
Correlation of serum hepcidin-25 levels with biochemical variables in patients with chronic kidney disease
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