| Objective:To study the different expression levels of serum and urine Hepcidin between health adults and kidney transplantation recipients and the association with ischemia reperfusion injury.Methods:From March 2013 to September 2014,30 health adults and 40 kidney transplantation recipients in PLA 309 Hospital were collected in our study. The recipients who received transplantation were not followed-up until they were out of hospital. We collected blood and urine specimens when the subjects received physical examination or during the graft recovery. Clinical data, renal function evaluation and transplant data were dissected. The expression levels of serum and urine Hepcidin and IL-6 were detected by ELISA detection kit. According to transplant or not and the different recovery after surgery, all were assigned to four groups:normal control (30), chronic kidney disease group (40), well graft function (28) and delayed graft function group (9). The data in this article were dissected by the 16.0 edition of Statistical Product and Service Solutions. The measurement data were dissected by t test or F test and the enumeration data by chi-square test. The different levels of serum and urine Hepcidin and IL-6 were compared among four groups and the association between them were dissected to study the possible mechanism.Results:(1) The dilution radio of serum and urine specimens were 1:200 and 1:100. Serum Hepcidin levels in CKD were significantly higher than normal control (66.9±7.5 μg/L vs 11.6±4.5μg/L,p=0.031); while the serum Hepcidin levels of first day in well graft function group were also significantly higher than that in CKD (169.4±12.7 μg/L vs 66.9±7.5 μg/L, p=0.008) and in DGF (169.4±12.7 μg/L vs 82. 1±20.9 μg/L, p=0.023). But the serum Hepcidin levels of first day in DGF were similar to CKD (82.1±20.9 μg/L vs 66.9±7.5 μg/L,p=0.057).(2) The subjects were similar in clinical data, renal function evaluation and transplant data. Before surgery, serum Hepcidin levels were similar between well and delayed graft function groups (71.2± 6.3 μg/L vs 69.5±7.1 μg/L,p=0.56>0.05); after surgery, serum Hepcidin levels in well graft function group were significantly higher than that in DGF and the peak was seen during 12 hours after reperfusion to the first day. All serum Hepcidin levels in these two groups after surgery were significantly different.(3) The serum Hepcidin and IL-6 levels in CKD group were dissected and correlation coefficient between them were r=0.5758 and p=0.021. But the correlation coefficient between serum Hepcidin and hemoglobin levels were r=-0.5313 and p=0.035. The serum Hepcidin of well graft function group in 12 hours after reperfusion were significantly higher than that in 6 hours (187.5±8.2 μg/L vs 105.8±11.2 μg/L,p=0.0083<0.01) and the same as serum IL-6 levels (23.2±4.9 μg/L vs 15.4±4.1 μg/L,p=0.041<0.05). Also, the correlations between the both in 6,12 hours after reperfusion and the first day were significantly positive (r1=0.5782, p1=0.032;r2=0.4471,p2=0.015;r3=0.5775,p3=0.007).(4) The serum Hepcidin levels were gradually cutting down in DGF during the first, second, third, fifth and seventh day of graft recovery. But there were no significantly differences in the ratio of urine Hepcidin and urine creatinine (p>0.05).Conclusion:The serum Hepcidin levels in well graft function group were significantly higher than that in DGF and this may be protection for IRI in kidney transplantation, while without sufficient levels may lead to DGF. The correlations between serum Hepcidin and IL-6 were significantly positive in CKD and well graft function group. Serum IL-6 levels may activate the increasing secretion of Hepcidin by Janus Kinases Signal Transducer. But serum Hepcidin levels were gradually cutting down in DGF during graft recovery and there were no significantly differences in the ratio of urine Hepcidin and urine creatinine. So Hepcidin may be inactive during the graft recovery in DGF. |
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