Abstract

The aim of our study was to examine the relationship of hepcidin-25 with red blood cell and reticulocyte indices and to evaluate the diagnostic properties of hepcidin-25 in the assessment of positive iron balance in end-stage renal disease (ESRD) patients. Eighty anemic ESRD patients (hemoglobin<110g/L) were classified as having iron deficiency (ID, N=20), iron sufficiency (IS, N=29), and positive iron balance (PB, N=31) using the conventional biomarkers for iron status evaluation. Hepcidin-25 was determined by a chemiluminescent direct ELISA. Hepcidin-25 was significantly negatively correlated with the proportion of hypochromic erythrocytes (%HYPO) (P=.034) and immature reticulocyte fraction (P=.010) in ID and with the absolute reticulocyte concentration in ID (P=.048) and PB (P=.040). In multivariate models, hepcidin-25 was independently negatively associated with the mean reticulocyte hemoglobin content (CHr; β=-0.493, P=.004) and red blood cell size factor (RSf) (β=-0.334, P=.036) only in the PB group. The best hepcidin-25 value to exclude PB was 66.13µg/L, showing a sensitivity of 61.3%, a specificity of 75.5%, and an AUC of 0.808. Our results suggest that hepcidin-25 levels are independently negatively associated with the iron demand for the most recent erythropoiesis only in PB. Hepcidin-25 performed acceptable in discriminating anemic ESRD patients with positive iron balance and may prove to be a useful additional tool in the evaluation of iron status.

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