Reduction of serum hepcidin by hemodialysis in pediatric and adult patients.

Publication/Presentation Date

6-1-2010

Abstract

BACKGROUND AND OBJECTIVES: Hepcidin, the principal regulator of iron homeostasis, may play a critical role in the response of patients with anemia to iron and erythropoiesis-stimulating agent therapy; however, the contribution of hepcidin to iron maldistribution and anemia in hemodialysis (HD) patients and the ability of HD to lower serum hepcidin levels have not been fully characterized.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We measured serum hepcidin using a competitive ELISA in 30 pediatric and 33 adult HD patients. In addition, we determined serum hepcidin kinetics and calculated hepcidin clearance by measuring serum hepcidin before, during, and after HD in eight pediatric and six adult patients.

RESULTS: Hepcidin was significantly increased in pediatric (median 240.5 ng/ml) and adult HD patients (690.2 ng/ml) when compared with their respective control subjects (pediatric 25.3 ng/ml, adult 72.9 ng/ml). Multivariate regression analysis showed that serum hepcidin was independently predicted by ferritin and high-sensitivity C-reactive protein in the pediatric group and ferritin, percentage of iron saturation, and high-sensitivity C-reactive protein in the adult group. Hepcidin levels decreased after dialysis from 532 +/- 297 to 292 +/- 171 ng/ml. Hepcidin clearance by HD was 141 +/- 40 and 128 +/- 44 ml/min in pediatric and adult patients, respectively (NS).

CONCLUSIONS: These findings suggest that hepcidin may mediate the negative effects of inflammation on both disordered iron metabolism and erythropoiesis in HD patients and that intensification of HD could be used therapeutically to reduce hepcidin concentrations and thereby improve erythropoiesis-stimulating agent responsiveness.

Volume

5

Issue

6

First Page

1010

Last Page

1014

ISSN

1555-905X

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

20299375

Department(s)

Department of Pediatrics

Document Type

Article

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