| Hepcidin is not useful as a biomarker for iron needs in haemodialysis patients on maintenance erythropoiesis-stimulating agents. | |
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MedLine Citation:
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PMID: 20538788 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-10 |
Journal Detail:
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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:
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Created Date: 2010-11-24 Completed Date: 2011-04-18 Revised Date: 2011-11-24 |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 3996-4002 Citation Subset: IM |
Affiliation:
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Hemodialysis Unit Ospedale Policlinico, Division of Nephrology, University of Verona, Verona, Italy. nicola.tessitore@ospedaleuniverona.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Anemia, Iron-Deficiency / blood, prevention & control* Antimicrobial Cationic Peptides / blood* Biological Markers / blood Female Hematinics / therapeutic use* Hemoglobins / metabolism Homeostasis / physiology Humans Injections, Intravenous Iron / administration & dosage, therapeutic use* Kidney Failure, Chronic / blood*, therapy* Male Middle Aged Multivariate Analysis Predictive Value of Tests Renal Dialysis* Retrospective Studies Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization |
| Grant Support | |
ID/Acronym/Agency:
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GGP06213//Telethon |
| Chemical | |
Reg. No./Substance:
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0/Antimicrobial Cationic Peptides; 0/Biological Markers; 0/Hematinics; 0/Hemoglobins; 0/hepcidin; 7439-89-6/Iron |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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