Evaluation of hepcidin level and its relation to iron status, inflammation and liver function in hemodialyzed patients

ABSTRACT

Hepcidin, a key regulator of iron metabolism by blocking its intestinal absorption and its release by the reticuloendothelial system, and modulated in response to anemia, hypoxia or inflammation. The aim of the study was to assess hepcidin correlations with markers of iron status, erythropoietin therapy, liver function and markers of inflammation in hemodialyzed [HD] patients. Fifty patients on regular HD [30 patients treated with erythropoietin and 20 patients without erythropoietin therapy] and 20 healthy controls were studied. Hepcidin and C-reactive protein [CRP] were measured. Iron status, complete blood count, liver function and lipid profile were assessed. The weekly erythropoietin dose and the patients demographics were recorded. In comparison to the healthy controls, the HD patients had higher serum ferritin, CRP and hepcidin levels. Serum iron, total iron binding capacity [TIBC], transferrin saturation [TSAT], erythrocyte count, hemoglobin [Hb], hematocrit [Hct], platelet count and albumin were low in HD patients. In the patient group, hepcidin level were positively correlated with leukocyte count, triglyceride, albumin, aspartate aminotransferase, ferritin and erythropoietin dose and negatively correlated with erythrocyte count, Hb and HCt values. In multiple regression analysis, triglyceride [beta value was 0.27, p <0.05] and albumin [beta value was - 0.30, p < 0.05] were correlated with hepcidin in HD patients. In conclusion, high serum levels of hepcidin in HD patients may be due to accumulation in the serum, low - grade inflammation, frequently found in HD patients may also contributed. Elevated hepcidin levels in HD patients could be responsible for functional iron deficiency and anemia and may be considered as a sensitive tool for functional iron deficiency in these patients