Plasma Hepcidin Level in Hemodialysis Patients and its Relationship to Anemia Therapy and Dialysis Efficiency

Abstract

Background: Hepcidin is a small peptide produced mainly by hepatocytes, macrophages and other cells. In addition to its antimicrobial effects, it is the primary regulator of iron metabolism as it controls both dietary iron absorption from the duodenum and the release of that iron by reticuloendothelial cells. Objective: Study of plasma hepcidin level and its relationship to the parameters of iron status, anemia therapy, and parameters of dialysis efficiency in hemodialysis patient. Patients and Methods: 106 subjects were enrolled in our study. They were divided into two groups: Group 1 (control group) included10 healthy subjects. Group 2 included96 end-stage renal disease (ESRD) patients on regular hemodialysis; they were subdivided into two groups according to the median plasma hepcidin level. full history, physical examination and detailed analysis of medical records to elucidate the cause of renal failure if present and duration of hemodialysis, estimation of glomerular filtration rate (eGFR) and calculating Kt/V. Laboratory investigations includingCBC, liver function tests, kidney function tests, serum iron, serum ferritin, total iron binding capacity (TIBC), transferrin saturation and plasma hepcidin level were measured. In addition to Pelvi-abdominal ultrasound was done. Results: Plasma hepcidin levels were higher in maintenance hemodialysis patients than in healthy control subjects. Also, there was a significant and independent positive correlation between hepcidin and both serum ferritin levels and KT/V. While there was significant negative correlation between serum hepcidin levels & EPO dose. Conclusion: High plasma hepcidin levels in HD patients depending on the magnitude of the inflammatory process and on rhEPO doses. Close interaction between hematological indices, iron status and plasma hepcidin levels.