Background: Anemia represents a significant problem to deal with in
patients with chronic kidney disease (CKD) on haemodialysis (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), erythropoietin resistance and
inflammatory markers (C-reactive protein). Methods: The study was
performed on (50 patients) with end stage renal disease on maintenance
haemodialysis. Patients were divided into two groups: group (I): 40 patients
who have anaemia responsive to erythropoietin therapy and group (II): 10
patients who have anaemia 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 resistance 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
resistance. 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. |
