Role of Hepcidin as a biomarker for iron status in patients on regular hemodialysis

Abstract

The etiology of anemia in End Stage Renal Disease is multifactorial. In addition to relative erythropoietin deficiency, shortened erythrocyte survival and the erythropoiesis inhibitory effects of accumulating uremic toxins also contribute to the anemia of CKD. Importantly, ESRD patients also have several abnormalities in systemic homeostasis of iron, an essential component in the production of red blood cells. Aim of the Work: to assess hepcidin level in regular hemodialysis patients with negative virology & its relation to iron status. Patients and Methods: This cross sectional study was conducted on 45 prevalent End Stage Kidney Stage patients. The patients on regular hemodialysis sessions three times weekly with low-flux synthetic membrane, bicarbonate dialysate & heparin as anticoagulant. In all patients the length of the dialysis session was set at 240 minutes, in Nasser Institute Dialysis Unit. Results: *******. Conclusion: Hepcidin plays a major role in regulation of dietary iron absorption and cellular iron release. Hepcidin is primarily associated with iron stores and involved in regulating iron availability for erythropoiesis in Hemodialysis patients. Hepcidin levels do not appear to help predict who will or will not have an improved Hemoglobin response to intravenous iron, since it doesn't perform better than the traditional markers of iron status (ferritin and TSAT). Increased hepcidin across the spectrum of CKD may contribute to abnormal iron regulation and erythropoiesis and may be a novel biomarker of iron status and erythropoietin resistance. Further studies including a large number of cases may be needed.