Study of serum hepcidin level and its relation to recombinant human erythropoietin resistence, markers of iron status and C-reactive protein in patients with end stage renal disease on maintenance hemodialysis.

Elbadawy, Ayman; Ibraheim, W. M.; Khalil, Medhat; Elhawary, omar; Abdelmoneim, Rasha

doi:10.21608/bmfj.2021.66540.1391

	Study of serum hepcidin level and its relation to recombinant human erythropoietin resistence, markers of iron status and C-reactive protein in patients with end stage renal disease on maintenance hemodialysis.
Benha Medical Journal
Article 8, Volume 38, Issue 2, July 2021, Page 497-510 PDF (602.08 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2021.66540.1391
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Authors
Ayman Elbadawy¹; W. M. Ibraheim¹; Medhat Khalil¹; omar Elhawary ²; Rasha Abdelmoneim¹
¹Internal Medicine, Faculty of Medicine, Banha University
²Internal Medicine Department, Faculty of Medicine, Benha University, Egypt
Abstract
Background: Anemia represents a significant problem to deal with in patients with chronic kidney disease (CKD) on hemodialysis (HD). This work aimed to determine the usefulness of measuring serum hepcidin level in patients with end stage renal disease (ESRD) on maintenance hemodialysis and anemia, and assess the possible correlation between serum hepcidin level and markers of iron status (serum iron, serum ferritin, total iron binding capacity and iron saturation), erythropiotin resistence and inflammatory markers (C-reactive protein). Methods: The study was performed on (50 patients) with end stage renal disease on maintainance hemodialysis. Patients were divided into two groups: group (I): 40 patients who have anemia responsive to erythropoietin therapy and group (II): 10 patients who have anemia resistant to erythropoietin therapy. All patients were subjected to thorough history taking, clinical examination, and laboratory investigations. Results: serum hepcidin level was higher in all patients with erythropoietin resistence index (ERI) < 15 compared to patients with ERI > 15. There was a highly significant positive correlation between serum hepcidin level and ERI and significant negative correlation between serum hepcidin level and serum iron, ferritin and transferrin saturation. But no significant correlation between serum hepcidin level and C-reactive protein. Conclusion: Hepcidin is associated with anemia, markers of iron status and erythropoietin resistence. If used as a diagnostic tool, it might improve iron therapy in patients with functional iron deficiency due to reticuloendothelial blockage of iron transport. This is important to avoid iron overload and to improve erythropoietin (EPO) response in patients with ESRD.
Keywords
Hepcidin; Erythropoietin resistance; Markers of iron status; Inflammatory markers


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