Role of hepcidin, altered iron metabolism and systemic inflammation in the pathogenesis of iron deficiency anemia, anemia of chronic disease, and iron refractory anemia in cirrhosis and ACLF.

Abstract

Background and Aim: Anemia of Chronic Disease (ACD), iron deficiency anemia (IDA), vitamin B12/folate deficiency and hemolysis are causes of anemia in cirrhosis and acute-on-chronic liver failure (ACLF). Standard tests of iron metabolism like transferrin and ferritin are affected by inflammation, making assessment of iron therapy unclear. Diagnostic accuracy can be improved by soluble transferrin receptor (sTfR) or hepcidin levels, as novel markers.