Hepcidin - A potential novel biomarker for iron status in chronic kidney disease

Joshua Zaritsky, Brian Y Young, He Jing Wang, Mark Westerman, Gordana Olbina, Elizabeta Nemeth, Tomas Ganz, Seth Rivera, Allen R. Nissenson, Isidro B. Salusky

Research output: Contribution to journalArticlepeer-review

211 Scopus citations

Abstract

Background and objectives: Hepcidin is a key regulator of iron homeostasis, but its study in the setting of chronic kidney disease (CKD) has been hampered by the lack of validated serum assays. Design, setting, participants, & measurements: This study reports the first measurements of bioactive serum hepcidin using a novel competitive ELISA in 48 pediatric (PCKD2-4) and 32 adult (ACKD2-4) patients with stages 2 to 4 CKD along with 26 pediatric patients with stage 5 CKD (PCKD5D) on peritoneal dialysis. Results: When compared with their respective controls (pediatric median = 25.3 ng/ml, adult = 72.9 ng/ml), hepcidin was significantly increased in PCKD2-4 (127.3 ng/ml), ACKD2-4 (269.9 ng/ml), and PCKD5D (652.4 ng/ml). Multivariate regression analysis was used to assess the relationship between hepcidin and indicators of anemia, iron status, inflammation, and renal function. In PCKD2-4 (R 2 = 0.57), only ferritin correlated with hepcidin. In ACKD2-4 (R 2 = 0.78), ferritin and soluble transferrin receptor were associated with hepcidin, whereas GFR was inversely correlated. In PCKD5D (R 2 = 0.52), percent iron saturation and ferritin were predictors of hepcidin. In a multivariate analysis that incorporated all three groups (R 2 = 0.6), hepcidin was predicted by ferritin, C-reactive protein, and whether the patient had stage 5D versus stages 2 to 4 CKD. Conclusions: These findings suggest that increased hepcidin across the spectrum of CKD may contribute to abnormal iron regulation and erythropoiesis and may be a novel biomarker of iron status and erythropoietin resistance.

Original languageEnglish (US)
Pages (from-to)1051-1056
Number of pages6
JournalClinical Journal of the American Society of Nephrology
Volume4
Issue number6
DOIs
StatePublished - Dec 1 2009

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

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