Relationship between serum hepcidin level and iron metabolism in patients with end-stage renal disease

Objective To investigate the relationship between serum hepcidin level and iron metabolism in end-stage renal disease(ESRD) patients with maintenance hemodialysis(MHD) and those without dialysis.Methods A total of 30 ESRD patients with MHD,30 ESRD patients without dialysis,and 30 healthy people as the controls were enrolled in this study.Serum hepcidin and total iron-binding capacity(TIBC) were measured by ELISA.Serum Fe,ferritin(FER) and transferrin(TRF) were measured by routine methods.Data were compared among the groups.Results(a) Serum hepcidin was significantly higher in ESRD patients on MHD and those without dialysis than in healthy control group(P0.01).(b) Serum hepcidin was higher in ESRD patients on MHD than in those without dialysis(P0.05).(c) Pearson correlation analyses revealed that serum hepcidin was positively correlated with Scr(r=0.969),hs-CRP(r=0.515),iPTH(r=0.290),and FER(r=0.286)(P0.05),and was negatively correlated with HGB(r=-0.543),RBC(r=-0.540),eGFR(r=-0.534),HCT(r=-0.466),TRF(r=-0.362),(r=-0.360),TIBC(r=-0.285),ALB(r=-0.248),and TP(r=-0.224)(P0.05).(d) Multiple regression analyses showed that RBC,HGB,hs-CRP,FER,TRF,and TIBC were closely associated with serum hepcidin level in ESRD patients without dialysis,and RBC,HGB,eGFR,FER,and TIBC were closely associated with serum hepcidin level in ESRD patients on MHD.(e) In ESRD patients without dialysis,the area of serum hepcidin under the ROC curve is 86.3%,and the sensitivity and specificity are 76.7% and 99.1%,respectively.In ESRD patients on MHD,the area of serum hepcidin under the ROC curve is 84.6%,and the sensitivity and specificity are 73.0% and 99.8%,respectively.In MHD patients,the area of serum hepcidin under the ROC curve is 84.6%.The sensitivity and specificity were 73.0% and 99.8%,respectively.Conclusions Serum hepcidin level increases in ESRD patients.Serum hepcidin may contribute to the abnormal iron metabolism and erythropoiesis,and may be a novel serum marker to iron status.