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
Published In/Presented At
Zaritsky, J., Young, B., Gales, B., Wang, H. J., Rastogi, A., Westerman, M., Nemeth, E., Ganz, T., & Salusky, I. B. (2010). Reduction of serum hepcidin by hemodialysis in pediatric and adult patients. Clinical journal of the American Society of Nephrology : CJASN, 5(6), 1010–1014. https://doi.org/10.2215/CJN.08161109
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
20299375
Department(s)
Department of Pediatrics
Document Type
Article