The Expression Level Of Serum Hepcidin In Patients With Chronic Kidney Disease And Its Correlation With Vitamin D

Objective: To study the expression level of serum hepcidin in patients with chronic kidney disease and its relationship with the level of 25 hydroxy vitamin D(25(OH)D).Methods:(1)The object of study: 60 patients with maintenance hemodialysis(MHD),30 patients with continuous ambulatory peritoneal dialysis(CAPD),35 patients with chronic renal failure no-dialysis patients(no-dialysis CKD4-5 group)and 30 healthy cases as the controls were enrolled in this study.(2)Clinical indexes:Serum hepcidin and serum 25(OH)D were measured by ELISA.Red blood cell(RBC),hemoglobin(Hb),hematokrit(Hct),serum ferritin(SF),serum iron(SI),Transferrin saturation(TSAT)and c-reactive protein(CRP)were measured by routine methods.(3)Experimental group:Group 1:CKD patients were divided into MHD group,CAPD group and no-dialysis CKD group according to the dialysis method,and the health examination population was taken as the control group,analysis the relationship between the serum hepcidin and clinical parameters.Group 2: according to the level of serum 25(OH)D,MHD patients were divided into vitamin D deficiency group,vitamin D insufficient group and vitamin D normal group,observed the relationship among 25(OH)D and serum hepcidin and other clinical indexes.(4)Statistical analysis:Statistical analysis was performed using SPSS software,measurem-ent data were expressed as mean ± standard deviation,the groups were compared using one-way ANOVA or Kruskall Wallis H,two independent groups were compared using independent samples t test or rank sum test,Pearson correlation analysis was used to analysis correlation analysis,Multivariate linear regression analysis was performed with statistical significance in the correlation analysis.P<0.05 was considered statistically significant.P<0.01 was considered remarkable statistically significant.Results:(1)Hepcidin levels in MHD group,CAPD group,no-dialysis CKD group and normal group respectively were91.82±21.39ug/L,85.84±16.32ug/L,58.91±15.74ug/Land46.94±5.95ug/L.Hepcidin in MHD group was higher than that of no dialysis CKD group and control group,the difference is significant(P<0.01),hepcidin in MHD group is higher than that of the CAPD group,the difference was not statistically significant(P>0.05);hepcidin in CAPD was higher than that of no dialysis CKD group and control group,the difference is significant(P<0.01);hepcidin in no dialysis CKD group was higher than that of the control group,the difference is significant(P < 0.01).(2)Analysis of the correlation between level of serum hepcidin and clinical indicators:in CKDpatients,serum hepcidin were negatively correlate with RBC,Hb,Hct,SI and positively correlate with SF,CRP,BUN.Multivariate linear regression analysis was performed with statistical significance in the correlation analysis.(3)Serum25(OH)D indeficiency group,insuffcient group were negatively correlated with hepcidin(r=-0.578,-0.496,P<0.05)and CRP(r=-0.642,-0.428,P< 0.05).Conclusions:(1)In CKD4-5 patients,the level of hepcidin expression was increased,especially in the MHD group.(2)There was no significant difference in the expression level of hepcidin in the two different dialysis methods of maintenance hemodialysis and continuous ambulatory peritoneal dialysis.(3)The expression level of Hepcidin was related to anemia,inflammation and iron status,reducing the level of inflammation and iron status may increase the expression of hepcidin.(4)Vitamin D deficiency in CKD patients affected the expression of hepcidin,the lower level of vitamin D,the higher expression of hepcidin.