Document Detail

Hepcidin is not useful as a biomarker for iron needs in haemodialysis patients on maintenance erythropoiesis-stimulating agents.
MedLine Citation:
PMID:  20538788     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been suggested that hepcidin may be useful as a tool for managing iron therapy in haemodialysis (HD) patients on erythropoiesis-stimulating agents (ESA).
METHODS: We used SELDI-TOF mass spectrometry assay to measure serum hepcidin-25 (Hep-25) and hepcidin-20 (Hep-20) in 56 adult HD patients on maintenance ESA to assess their ability to predict haemoglobin (Hb) response after 1 g intravenous iron (62.5 mg ferric gluconate at 16 consecutive dialysis sessions) and their relationship with markers of iron status, inflammation and erythropoietic activity.
RESULTS: At multivariate analysis (in a model that also included Hb, reticulocyte, ESA dose, HFE genotype, soluble transferrin receptor [sTfR] and C-reactive protein), Hep-25 independently correlated with ferritin (β = 0.03, P = 0.01) and the percentage of hypochromic red blood cells [%Hypo] (β = 1.84, P = 0.01), suggesting that Hep-25 may be a useful biomarker for iron stores and bone marrow iron availability. Hep-20 correlated independently with Hep-25 (β = 0.159, P < 0.001) and ferritin (β = 0.006, P = 0.05), suggesting that it may be a useful additional biomarker for iron stores. On receiver operating characteristics curve analysis, neither Hep-25 nor Hep-20 significantly predicted who will increase their Hb after iron loading (AUC = 0.52 ± 0.09 and 0.54 ± 0.08, P = 0.612), and the same applied to ferritin and transferrin saturation (AUC = 0.55 ± 0.08 and 0.59 ± 0.08, P = 0.250), whereas %Hypo and reticulocyte Hb content were significant predictors (AUC = 0.84 ± 0.05 and 0.70 ± 0.08, P < 0.01). At multivariate logistic regression analysis, %Hypo was the only biomarker independently associated with iron responsiveness.
CONCLUSIONS: Although our study suggests an important role for hepcidin in regulating iron homeostasis in HD patients on ESA, our findings do not support its utility as a predictor of iron needs, offering no advantage over established markers of iron status.
Nicola Tessitore; Domenico Girelli; Natascia Campostrini; Valeria Bedogna; Giovanni Pietro Solero; Annalisa Castagna; Edoardo Melilli; William Mantovani; Giovanna De Matteis; Oliviero Olivieri; Albino Poli; Antonio Lupo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-10
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-04-18     Revised Date:  2011-11-24    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  3996-4002     Citation Subset:  IM    
Hemodialysis Unit Ospedale Policlinico, Division of Nephrology, University of Verona, Verona, Italy.
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MeSH Terms
Aged, 80 and over
Anemia, Iron-Deficiency / blood,  prevention & control*
Antimicrobial Cationic Peptides / blood*
Biological Markers / blood
Hematinics / therapeutic use*
Hemoglobins / metabolism
Homeostasis / physiology
Injections, Intravenous
Iron / administration & dosage,  therapeutic use*
Kidney Failure, Chronic / blood*,  therapy*
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Renal Dialysis*
Retrospective Studies
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Grant Support
Reg. No./Substance:
0/Antimicrobial Cationic Peptides; 0/Biological Markers; 0/Hematinics; 0/Hemoglobins; 0/hepcidin; 7439-89-6/Iron

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