ABSTRACT
Objective To examine the association of pro-hepcidin with iron metabolism and inflammation in maintenance hemodialysis (MHD) patients with erythropoietin (EPO) resistance.Methods Forty MHD patients and twenty healthy controls were enrolled in the study.Among MHD patients,20 were hyporesponsive to EPO therapy and 20 were normal responsive to EPO therapy.Complete blood red cell count (RBC),Hb concentration,hematocrit (Hct),reticulocyte count (Ret),and serum ferritin (SF),serum iron (Fe),total ironbinding capacity (TIBC),saturation rate of transferrin (TSAT),transferrin (TF),hyper-sensitive C-reactive protein (hs-CRP),pro-hepcidin were measured in all the patients and controls.Differences were compared between groups.Influencing factors were analyzed by Pearson correlation.Predicting value of pro-hepcidin was investigated by ROC curve.Results Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in MHD patients than those in healthy controls (P＜0.01),while serum TF was lower in MHD patients (P＜0.05).Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in EPO resistant patients as compared to normal responsive cases (P＜0.01).Serum prohepcidin level was positively correlated with SF (r=0.843,P=0.000) and hs-CRP (r=0.695,P=0.001).In predicting EPO resistance,area under ROC curve of pro-hepcidin,SF and hs-CRP was 0.713,0.769 and 0.958 respectively.Conclusions EPO resistance is correlated with inflammation and iron metabolism.Serum pro-hepcidin,SF and hs-CRP may be used as markers of EPO resistance in MHD patients.