Serum hepcidin is associated with iron status and micro-inflammation in hemodialysis patients

Objective To investigate the association of serum hepcidin,iron status and micro-inflammation in maintenance hemodialysis(MHD) patients.Methods Totally 48 MHD patients and 20 healthy subjects were enrolled in this study.Serum hepcidin and interleukin 6(IL-6) levels were measured by enzyme-linked immunosorbant assay(ELISA).Spearman correlation and linear regression were used to assess the relationship between serum hepcidin levels and other laboratory parameters in MHD patients.Results Serum hepcidin and IL-6 levels were significantly higher in MHD patients than those in normal controls(225.6 [146.4-455.9] μg/L vs.90.4 [54.5-171.5] μg/L,P0.05;48 [35.0-97.2] ng/L vs.43.9 [26.5-51.6] ng/L,P0.05).Spearman correlation showed that serum hepcidin levels in MHD patients were positively correlated with ferritin(ρ=0.892),transferrin saturation(TSAT,ρ=0.289) and IL-6(ρ=0.439),and negatively correlated with unsaturated iron-binding capacity(UIBC,ρ=-0.570),total iron-binding capacity(TIBC,ρ=-0.552) and transferrin(ρ=-0.532).Linear regression analysis showed that ferritin(non-standardized regression coefficient was 0.761,standardized regression coefficient was 0.736,P0.001) and TIBC(non-standardized regression coefficient was-5.654,standardized regression coefficient was-0.204,P=0.034) were independently associated with serum hepcidin levels.Conclusion Serum hepcidin levels are markedly elevated and are associated with iron status and micro-inflammation in MHD patients.ELISA is an available method for the measurement of serum hepcidin in clinical practice.Serum hepcidin,high-sensitivity C-reactive protein(hsCRP) and iron status are indicators of iron administration for anemia in MHD patients.