Abstract:
Patients on hemodialysis (HD) are usually anemic because of defective erythropoeisis.
Hepcidin is a polypeptide that regulates iron homeostasis and could serve as an indicator
of functional iron deficiency in patients with end-stage renal disease (ESRD); this may also aid in
the assessment of patient’s response to erythropoietin (EPO). The present study was directed to
investigate serum levels of hepcidin, iron status and inflammation markers such as C-reactive
protein (CRP) in patients with ESRD on maintenance HD and to observe the correlation of serum
hepcidin with conventional iron and inflammatory markers. A total of 42 patients of both sexes on
maintenance HD and EPO therapy were enrolled; 42 age- and sex-matched healthy subjects were
included as controls. Laboratory tests including complete blood count, serum hepcidin, total iron
binding capacity (TIBC), serum ferritin, serum iron and CRP were performed. Serum hepcidin
levels were significantly higher in patients with ESRD than in the control group (18.2 ± 2.8
ng/mL and 8.5 ± 2.3 ng/mL, respectively P = 0.000). The hemoglobin, hematocrit, serum iron,
TIBC and transferrin saturation levels in the patient group were significantly lower than in the
control group. Higher hepcidin levels were found in EPO non-responders (19.6 ± 2.4 ng/mL)
while lower levels (16.9 ± 2.5 ng/mL) were seen in responders (P = 0.001). A positive and
significant correlation was observed between the values of serum hepcidin and CRP. Our study
indicates that higher hepcidin levels are found in ESRD patients on HD and in those not
responding to EPO. Our findings suggest that hepcidin might play a role in the pathophysiology
of anemia associated with chronic diseases as well as EPO resistance.
