Plasma Prohepcidin Positively Correlates with Hematocrit in Chronic Hemodialysis Patients

Hsu, Shih Ping; Chiang, Chih Kang; Chien, Chiang Ting; Hung, Kuan‐Yu

doi:10.1159/000091453

Cited by 30 publications

(37 citation statements)

References 29 publications

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“…5,12,20 Similar inconsistencies are apparent in the literature as to the relationship between pro-hepcidin and hemoglobin/hematocrit levels: either inverse 13,21 or direct, positive correlations. 22 In contrast to these studies, we observed no signifi cant correlation between pro-hepcidin and hemoglobin even. Again, in this controversial area, our data are not singular, as Taes et al-in pre-dialysis patients-also failed to detect a relation between pro-hepcidin levels and hematocrit.…”

Section: Discussioncontrasting

confidence: 95%

Pro‐Hepcidin Levels in Peritoneal Dialysis and Hemodialysis Patients

Turgut

Kanbay

Altay

et al. 2009

Dialysis & Transplantation

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OBJECTIVEAnemia is a major clinical problem in patients receiving dialysis therapy and has a substantial impact on morbidity and mortality. Iron metabolism is impaired in chronic kidney disease. Hepcidin functions as a key regulator of iron metabolism. The aims of this study were to compare the serum pro‐hepcidin levels in patients with either peritoneal dialysis (PD) or hemodialysis (HD) and control subjects and to evaluate pro‐hepcidin and C‐reactive protein (CRP), iron parameters, and hemoglobin levels in PD and HD patients with normal serum CRP levels.METHODSWe studied 85 PD patients, 43 HD patients on regular follow‐up, and a control group that was comprised of 41 volunteers in this cross‐sectional study. Pro‐hepcidin and CRP were studied using commercially available kits. Iron status was assessed by measuring serum iron, transferrin saturation, and ferritin.RESULTSPro‐hepcidin levels were significantly higher in dialysis patients than the control subjects (p < .001). Hemodialysis patients had higher pro‐hepcidin levels than PD patients; but, this difference was not statistically significant (393.4 ± 157.3 versus 361.3 ± 40.1, p = .19). There were no correlations between pro‐hepcidin levels and CRP, and hemoglobin level and iron parameters in PD and HD patients.CONCLUSIONThe present results suggest that dialysis therapy is associated with elevated pro‐hepcidin levels and not directly related to CRP, indices of iron metabolism, or hemoglobin levels. Peritoneal dialysis patients have relatively lower pro‐hepcidin levels than HD patients, but larger‐scale studies are needed to confirm the possibility of impact on various dialytic modalities.

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Section: Discussioncontrasting

confidence: 95%

Pro‐Hepcidin Levels in Peritoneal Dialysis and Hemodialysis Patients

Turgut

Kanbay

Altay

et al. 2009

Dialysis & Transplantation

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“…The increased hepcidin expression during inflammation and infection explains sequestration of iron in the macrophages and inhibition of intestinal iron absorption, the two hallmarks of the anemia of inflammation, which is normocytic or microcytic and hypochromic. [25][26][27] HD patient's non-responders to rhEPO therapy presented a mild anemia, even with the administration of higher rhEPO doses. This anemia is hypochromic (decreased MCH and MCHC), and is associated with a more accentuated anisocytosis than in responder patients.…”

Section: Discussionmentioning

confidence: 99%

Body mass index and resistance to recombinant human erythropoietin therapy in maintenance hemodialysis patients

et al. 2013

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The aim of this work was to contribute to a better understanding of the relationship between resistance to recombinant human erythropoietin (rhEPO) therapy and body mass index (BMI) in hemodialysis (HD) patients. We evaluated 191 HD patients and 25 healthy individuals. Complete blood count, reticulocyte count, and circulating levels of ferritin, transferrin, iron, soluble transferrin receptor (sTfR), transferrin saturation, hepcidin, C-reactive protein (CRP), interleukin 6 (IL-6), albumin, and adiponectin were measured in all patients and controls. Nonresponder patients (n ¼ 16), as compared with responder patients (n ¼ 175), showed statistically significant lower BMI values, an enhanced inflammatory and higher adiponectin levels, associated with disturbances in iron metabolism. Analyzing the results according to BMI, we found that underweight patients required higher rhEPO doses than normal, overweight, and obese patients, and a higher percentage of non-responders patients were found within the underweight group of HD patients. Moreover, underweight patients presented lower levels of transferrin and higher levels of adiponectin compared to overweight and obese patients, and lower levels of iron compared with normal weight patients. Multiple regression analysis identified the sTfR, hemoglobin, BMI, and albumin as independent variables associated with rhEPO doses. In conclusion, our work showed that HD patients resistant to rhEPO therapy present a functional iron deficiency and a higher degree of inflammation, despite their lower BMI values and higher levels of adiponectin. Actually, BMI is poorly related with markers of systemic inflammation, such as IL-6 and CRP, while adiponectin works a fairly good indirect marker of adiposity within HD patients.

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“…They found no relation between prohepcidin and ferritin and TSAT. Hsu et al [18] also demonstrated that plasma prohepcidin correlated positively with hematocrit (Hct) but negatively with rHuEPO dosage. In contrast, Malyszko et al [19] showed a positive association between prohepcidin and rHuEPO dose in the HD patients treated with rHuEPO.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is likely therefore that prohepcidin may not be a reliable marker for assessing rHuEPO responsiveness in HD patients. In addition, limitations of this ELISA system cannot be ruled out as a possible explanation for the previous inconsistent results between prohepcidin and rHuEPO responsiveness and renal anemia [9,18,19,20]. …”

Section: Discussionmentioning

confidence: 99%

Association of Prohepcidin and Hepcidin-25 with Erythropoietin Response and Ferritin in Hemodialysis Patients

Kato¹,

Tsuji

Luo

et al. 2007

Am J Nephrol

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Hepcidin is a key regulator of iron metabolism. In this study, we examined whether measurement of hepcidin is useful in assessing recombinant human erythropoietin (rHuEPO) responsiveness in regular hemodialysis (HD) patients in a cross-sectional fashion. We examined the association between serum prohepcidin, a prohormone of hepcidin, and rHuEPO dosage and the rHuEPO/hemoglobin (Hb) ratio in 75 HD patients. We also semiquantatively measured the peak intensity of serum hepcidin-25, the major form of mature hepcidin, in 24 HD patients by using surface-enhanced laser desorption ionization time of flight time mass spectrometry, and compared those between rHuEPO-hyporesponsive (rHuEPO 192 ± 10 [126–252] IU/kg/week, n = 15) and responsive patients (rHuEPO 40 ± 9 [0–81] U/kg/week, n = 9). A significant but weak relationship was found between serum prohepcidin and rHuEPO dosage (r = 0.24, p < 0.05) and rHuEPO/Hb ratio (r = 0.22, p = 0.06). However, prohepcidin did not become an indicator of hematopoietic parameters by multiple regression analysis. Serum hepcidin-25 intensity was significantly and positively correlated with ferritin (r = 0.51, p < 0.01) but not with log-transformed C-reactive protein. There was no difference in the intensities of serum hepcidin-25 between rHuEPO-hyporesponsive and responsive patients (64 ± 10 vs. 52 ± 16 AU, p = NS). It follows from these findings that the assessment of serum hepcidin using currently available assays was not valid in predicting rHuEPO responsiveness in chronic HD patients.

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Plasma Prohepcidin Positively Correlates with Hematocrit in Chronic Hemodialysis Patients

Cited by 30 publications

References 29 publications

Pro‐Hepcidin Levels in Peritoneal Dialysis and Hemodialysis Patients

Pro‐Hepcidin Levels in Peritoneal Dialysis and Hemodialysis Patients

Body mass index and resistance to recombinant human erythropoietin therapy in maintenance hemodialysis patients

Association of Prohepcidin and Hepcidin-25 with Erythropoietin Response and Ferritin in Hemodialysis Patients

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