Relationship Between Serum Hepcidin Levels And The Iron Metabolism In Patients With Hemodialysis

Objective To investigate the serum Hepcidin level and the relationship with iron metabolism in maintenance hemodialysis patients (MHD) and non-dialysis patients with end-stage renal disease (ESRD). Methods Thirty MHD patients and thirty non-dialysis patients with ESRD were included in our study, and thirty normal healthy people for contrast. Serum Hepcidin and total iron-binding capacity (TIBC) were measured by ELISA, SI, FER, TRF and other indicators were measured routinely and compared. Results①Serum Hepcidin level was significantly higher in MHD patients and non-dialysis patients with ESRD than that in healthy control group (P<0.01).②Serum Hepcidin of MHD patients was higher than in non-dialysis patients with ESRD (P<0.05).③Pearson correlation analysis revealed serum Hepcidin was positively correlated with Scr (r=0.969), hs-CRP (r=0.515), iPTH (r=0.290), FER (r=0.286), (p<0.05); while negatively with HGB(r=-0.543), RBC(r=-0.540), eGFR(r=-0.534), HCT(r=-0.466), TRF(r=-0.362),SI(R=-0.360),TIBC(r=-0.285),ALB(r= -0.248),TIBC(r=-0.285), ALB(r=-0.248), TP(r=-0.224), (P<0.05).④Multiple regression analysis showed RBC, HGB, hs-CRP, FER, TRF, TIBC were closely associated with the level of serum Hepcidin in non-dialysis patients with ESRD; While RBC, HGB, eGFR, FER, TIBC were closely associated with the level of serum Hepcidin in MHD patients.⑤In non-dialysis patients with ESRD, the area of serum hepcidin under the ROC curve is 86.3%.The sensitivity and specificity were 76.7% and 99.1%, respectively. In maintenance hemodialysis patients, the area of serum hepcidin under the ROC curve is 84.6%. The sensitivity and specificity were 73.0% and 99.8%, respectively. Conclusions①Serum Hepcidin level was significantly higher in MHD patients and non-dialysis patients with ESRD than that in healthy control group.②.Serum Hepcidin of MHD patients was higher than in non-dialysis patients with ESRD.③These findings suggest that increased Hepcidin may contribute to abnormal iron regulation and erythropoiesis.④Serum Hepcidin on the diagnosis of functional iron deficiency was high sensitivity and specificity and may be a novel serum marker of iron status.