Relationship Between Hepcidin, Ferritin and C-Reactive Protein in Hemodialysis Patients

Elmenyawi, Azza A. I.; Hassan, Ahmed; Said, Seham A.; Sawar, Sherif

doi:10.12816/0040604

Relationship Between Hepcidin, Ferritin and C-Reactive Protein in Hemodialysis Patients

Document Type : Original Article

Authors

¹ Clinical pathologyNational Institute of Urology and Nephrology, Egypt

² NephrologyNational Institute of Urology and Nephrology, Egypt

³ Microbiology National Institute of Urology and Nephrology, Egypt

⁴ Urology Departments, National Institute of Urology and Nephrology, Egypt

10.12816/0040604

Abstract

Objective: Uremia is a state of heightened inflammatory activation. This might have an impact on several parameters including those used in the management of anemia as ferritin, serum iron, transferrin saturation, C-reactive protein (CRP) and hepcidin levels. In spite of this complexity the existing data indicate that hepcidin has an advantage over ferritin in guiding treatment of anemia in patients with chronic kidney disease (CKD) as it directly reflects iron availability and the status of iron homeostasis.
Aim of the study: was to determine serum hepcidin levels in maintenance haemodialysis (HD) patients and to investigate its relation to ferritin and markers of inflammation as C-reactive protein.
Subjects and methods: This study was conducted on 40 maintenance haemodialysis patients and 20 age-matched apparently healthy controls from October 2015 till February 2016 at the Haemodialysis Departement, National Institute of Urology and Nephrology (NIUN). Creatinine, albumin, hemoglobin, leucocytic count, CRP, hepcidin and ferritin were measured.
Results: Serum ferritin and hepcidin levels were significantly higher in HD patients compared with controls (825.67 ± 956.52 ng/ml and 9.2 ± 4.2 ng/ml vs 85.1± 63.35 ng/ml and 0.75 ± 0.39 ng/ml respectively) (p< 0.001).There was significant difference in CRP in HD patients compared with controls (4.28 ± 3.7mg/L vs 1.35±1.04mg/L respectively)(p<0.05).There were insignificant positive weak correlations between serum levels of hepcidin and ferritin (r = 0.05, P = 0.74).
Conclusion: Serum hepcidin levels are increased in HD patients and, hence, could be used in the evaluation of anemia in such patients. Serum hepcidin provides useful information about the level and availability of iron during inflammation as compared with traditional markers of iron status. Availability of the ELISA assay for serum hepcidin will facilitate the routine measurement of hepcidin in clinical practice.

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