Bone marrow iron distribution, hepcidin, and ferroportin expression in renal anemia

Bârsan, Liliana; Stanciu, Ana; Sica, Simona; Căpuşă, Cristina; Bratescu, Lavinia; Mandache, E; Radu, Eugen; Mircescu, Gabriel

doi:10.1179/1607845415y.0000000004

Cited by 21 publications

(28 citation statements)

References 28 publications

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“…However, we previously demonstrated that the serum hepcidin level can be exclusively associated with the ferritin level in patients on MHD in the absence of apparent inflammation and independent of the levels of inflammatory cytokines [27] . Several reports have confirmed these observations [28][29][30] . These data suggest that excessive iron storage or administration increases hepcidin levels and accelerates iron sequestration in most of the cells in the body ( fig.…”

Section: Host Factorssupporting

confidence: 71%

Iron Localization and Infectious Disease in Chronic Kidney Disease Patients

Nakanishi

Kuragano²,

Nanami³

et al. 2016

Am J Nephrol

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For patients on dialysis, infection is the second leading cause of mortality. Iron metabolism should be considered in the pathogenesis of infectious disease, as high local iron concentrations favor the growth of many microbes. This review is intended to provide information regarding iron metabolism and infection in chronic kidney disease (CKD) patients. There are 2 reasons these patients may be vulnerable to infection: (1) the excessive iron administered to treat renal anemia could be associated with impairments of the host's innate immune response, (2) CKD-associated inflammation could cause dysregulated iron metabolism. Pathogenic microorganisms can be categorized as extracellular or intracellular pathogens. The proliferation site may determine the degree of virulence. In cases of mainly extracellular microbial growth, the host's strategy of sequestering iron in cells may efficiently inhibit proliferation. However, the same strategy may favor the intracellular growth of microorganisms. The administration of excessive amounts of iron may modify iron localization by an increase in the hepcidin concentration. We conclude that there is a need for large multicenter randomized controlled trials to evaluate the long-term safety of different iron administration patterns that allow for a lower infection rate while still producing efficient erythropoiesis in CKD patients.

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Section: Host Factorssupporting

confidence: 71%

Iron Localization and Infectious Disease in Chronic Kidney Disease Patients

Nakanishi

Kuragano²,

Nanami³

et al. 2016

Am J Nephrol

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“…However, the overall event rate was relatively small, while overall a greater proportion of ESRD participants actually met a more stringent biochemical definition of iron sufficiency during this period. However, we recognize that biochemical measures of iron stores may under-diagnosis deficiency at the bone marrow level,[20] and therefore we cannot exclude the possibility of a greater prevalence of iron deficiency in these participants.…”

Section: Discussionmentioning

confidence: 99%

Change in Hemoglobin Trajectory and Darbepoetin Dose Approaching End-Stage Renal Disease: Data from the Trial to Reduce Cardiovascular Events with Aranesp Therapy Trial

et al. 2017

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Background: The pathogenesis of chronic kidney disease associated anemia is multifactorial and includes decreased production of erythropoietin (EPO), iron deficiency, inflammation, and EPO resistance. To better understand the trajectory of these parameters, we described temporal trends in hemoglobin (Hb), ferritin, transferrin saturation, C-reactive protein (CRP), and darbepoetin dosing in the Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT). Methods: We performed a post hoc analysis of 4,038 participants in TREAT. Mixed effects linear regression models were used to determine the trajectory of parameters of interest prior to end-stage renal disease (ESRD). Likelihood ratio tests were used to determine the overall differences in biomarker values and differences in trajectories between those who did and did not develop ESRD. Results: Hb declined precipitously in the year prior to the development of ESRD (irrespective of treatment assignment), and was on average 1.15 g/dL (95% CI –1.26 to –1.04) lower in those who developed ESRD versus those who did not, at the time of ESRD/end of follow-up. Simultaneously, the mean darbepoetin dose and CRP concentration increased, while serum ferritin and transferrin saturations were >140 μg/L and 20%, respectively. Conclusions: Our analyses provide descriptive insights regarding the temporal changes of Hb, darbepoetin dose, and related parameters as ESRD approaches in participants of TREAT. Hb declined as much as 1–2 years prior to the development of ESRD, without biochemical evidence of iron deficiency. The most precipitous decline occurred in the months immediately prior to ESRD, despite administration of escalating doses of darbepoetin and in parallel with an increase in CRP.

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“…On the other hand, hepcidin does not seem to be an important biomarker for predicting iron needs in patients on hemodialysis (HD) [76]. This finding does seem to be explained by the cause of redistribution of iron, which is not related only to changes in systemic, but probably also due to changes in local levels of hepcidin and/or FPN [77]. In any case, we still do not know the real extent of the value of hepcidin as a marker of renal anemia, especially its role in differentiating between ACD and iron deficient anemia (IDA), which are both present in kidney failure.…”

Section: Role Of Hepcidin In Renal Anemiamentioning

confidence: 99%

Systemic and local hepcidin as emerging and important peptides in renal homeostasis and pathology

Vela

2018

BioFactors

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Recent data suggest that the importance of hepcidin goes beyond its classical role in controlling systemic iron metabolism. Local hepcidins are emerging as important peptides for organ homeostasis in the brain, heart, blood vessels, and in cancer as well. Similarly, accumulating data indicate that hepcidin does seem to be an important factor in renal homeostasis. This review encompasses present knowledge concerning the role of hepcidin in renoprotection and its use as a biomarker of kidney diseases. Understanding the role of hepcidin in kidneys is important due to its relevance for kidney physiology and its potential therapeutic application in kidney pathologies. © 2018 BioFactors, 45(2):118–134, 2019

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Bone marrow iron distribution, hepcidin, and ferroportin expression in renal anemia

Cited by 21 publications

References 28 publications

Iron Localization and Infectious Disease in Chronic Kidney Disease Patients

Iron Localization and Infectious Disease in Chronic Kidney Disease Patients

Change in Hemoglobin Trajectory and Darbepoetin Dose Approaching End-Stage Renal Disease: Data from the Trial to Reduce Cardiovascular Events with Aranesp Therapy Trial

Systemic and local hepcidin as emerging and important peptides in renal homeostasis and pathology

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