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 journalArticle

197 Citations (Scopus)

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

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Hepcidins
Chronic Renal Insufficiency
Iron
Biomarkers
Ferritins
Pediatrics
Multivariate Analysis
Transferrin Receptors
Erythropoiesis
Peritoneal Dialysis
Erythropoietin
Serum
C-Reactive Protein
Anemia
Homeostasis
Enzyme-Linked Immunosorbent Assay
Regression Analysis
Inflammation
Kidney

ASJC Scopus subject areas

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

Cite this

Hepcidin - A potential novel biomarker for iron status in chronic kidney disease. / Zaritsky, Joshua; Young, Brian Y; Wang, He Jing; Westerman, Mark; Olbina, Gordana; Nemeth, Elizabeta; Ganz, Tomas; Rivera, Seth; Nissenson, Allen R.; Salusky, Isidro B.

In: Clinical Journal of the American Society of Nephrology, Vol. 4, No. 6, 01.12.2009, p. 1051-1056.

Research output: Contribution to journalArticle

Zaritsky, J, Young, BY, Wang, HJ, Westerman, M, Olbina, G, Nemeth, E, Ganz, T, Rivera, S, Nissenson, AR & Salusky, IB 2009, 'Hepcidin - A potential novel biomarker for iron status in chronic kidney disease', Clinical Journal of the American Society of Nephrology, vol. 4, no. 6, pp. 1051-1056. https://doi.org/10.2215/CJN.05931108
Zaritsky, Joshua ; Young, Brian Y ; Wang, He Jing ; Westerman, Mark ; Olbina, Gordana ; Nemeth, Elizabeta ; Ganz, Tomas ; Rivera, Seth ; Nissenson, Allen R. ; Salusky, Isidro B. / Hepcidin - A potential novel biomarker for iron status in chronic kidney disease. In: Clinical Journal of the American Society of Nephrology. 2009 ; Vol. 4, No. 6. pp. 1051-1056.
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AU - Young, Brian Y

AU - Wang, He Jing

AU - Westerman, Mark

AU - Olbina, Gordana

AU - Nemeth, Elizabeta

AU - Ganz, Tomas

AU - Rivera, Seth

AU - Nissenson, Allen R.

AU - Salusky, Isidro B.

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