Abstract
Background and objectives: Hepcidin, the principal regulator of iron homeostasis, may play a critical role in the response of patients with anemia to iron and erythropoiesis-stimulating agent therapy; however, the contribution of hepcidin to iron maldistribution and anemia in hemodialysis (HD) patients and the ability of HD to lower serum hepcidin levels have not been fully characterized. Design, setting, participants, & measurements: We measured serum hepcidin using a competitive ELISA in 30 pediatric and 33 adult HD patients. In addition, we determined serum hepcidin kinetics and calculated hepcidin clearance by measuring serum hepcidin before, during, and after HD in eight pediatric and six adult patients. Results: Hepcidin was significantly increased in pediatric (median 240.5 ng/ml) and adult HD patients (690.2 ng/ml) when compared with their respective control subjects (pediatric 25.3 ng/ml, adult 72.9 ng/ml). Multivariate regression analysis showed that serum hepcidin was independently predicted by ferritin and high-sensitivity C-reactive protein in the pediatric group and ferritin, percentage of iron saturation, and high-sensitivity C-reactive protein in the adult group. Hepcidin levels decreased after dialysis from 532 ± 297 to 292 ± 171 ng/ml. Hepcidin clearance by HD was 141 ± 40 and 128 ± 44 ml/min in pediatric and adult patients, respectively (NS). Conclusions: These findings suggest that hepcidin may mediate the negative effects of inflammation on both disordered iron metabolism and erythropoiesis in HD patients and that intensification of HD could be used therapeutically to reduce hepcidin concentrations and thereby improve erythropoiesis-stimulating agent responsiveness.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1010-1014 |
| Number of pages | 5 |
| Journal | Clinical Journal of the American Society of Nephrology |
| Volume | 5 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2010 |
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ASJC Scopus subject areas
- Nephrology
- Transplantation
- Epidemiology
- Critical Care and Intensive Care Medicine
- Medicine(all)
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Reduction of serum hepcidin by hemodialysis in pediatric and adult patients. / Zaritsky, Joshua; Young, Brian Y; Gales, Barbara; Wang, He Jing; Rastogi, Anjay; Westerman, Mark; Nemeth, Elizabeta; Ganz, Tomas; Salusky, Isidro B.
In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 6, 01.06.2010, p. 1010-1014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reduction of serum hepcidin by hemodialysis in pediatric and adult patients
AU - Zaritsky, Joshua
AU - Young, Brian Y
AU - Gales, Barbara
AU - Wang, He Jing
AU - Rastogi, Anjay
AU - Westerman, Mark
AU - Nemeth, Elizabeta
AU - Ganz, Tomas
AU - Salusky, Isidro B.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - Background and objectives: Hepcidin, the principal regulator of iron homeostasis, may play a critical role in the response of patients with anemia to iron and erythropoiesis-stimulating agent therapy; however, the contribution of hepcidin to iron maldistribution and anemia in hemodialysis (HD) patients and the ability of HD to lower serum hepcidin levels have not been fully characterized. Design, setting, participants, & measurements: We measured serum hepcidin using a competitive ELISA in 30 pediatric and 33 adult HD patients. In addition, we determined serum hepcidin kinetics and calculated hepcidin clearance by measuring serum hepcidin before, during, and after HD in eight pediatric and six adult patients. Results: Hepcidin was significantly increased in pediatric (median 240.5 ng/ml) and adult HD patients (690.2 ng/ml) when compared with their respective control subjects (pediatric 25.3 ng/ml, adult 72.9 ng/ml). Multivariate regression analysis showed that serum hepcidin was independently predicted by ferritin and high-sensitivity C-reactive protein in the pediatric group and ferritin, percentage of iron saturation, and high-sensitivity C-reactive protein in the adult group. Hepcidin levels decreased after dialysis from 532 ± 297 to 292 ± 171 ng/ml. Hepcidin clearance by HD was 141 ± 40 and 128 ± 44 ml/min in pediatric and adult patients, respectively (NS). Conclusions: These findings suggest that hepcidin may mediate the negative effects of inflammation on both disordered iron metabolism and erythropoiesis in HD patients and that intensification of HD could be used therapeutically to reduce hepcidin concentrations and thereby improve erythropoiesis-stimulating agent responsiveness.
AB - Background and objectives: Hepcidin, the principal regulator of iron homeostasis, may play a critical role in the response of patients with anemia to iron and erythropoiesis-stimulating agent therapy; however, the contribution of hepcidin to iron maldistribution and anemia in hemodialysis (HD) patients and the ability of HD to lower serum hepcidin levels have not been fully characterized. Design, setting, participants, & measurements: We measured serum hepcidin using a competitive ELISA in 30 pediatric and 33 adult HD patients. In addition, we determined serum hepcidin kinetics and calculated hepcidin clearance by measuring serum hepcidin before, during, and after HD in eight pediatric and six adult patients. Results: Hepcidin was significantly increased in pediatric (median 240.5 ng/ml) and adult HD patients (690.2 ng/ml) when compared with their respective control subjects (pediatric 25.3 ng/ml, adult 72.9 ng/ml). Multivariate regression analysis showed that serum hepcidin was independently predicted by ferritin and high-sensitivity C-reactive protein in the pediatric group and ferritin, percentage of iron saturation, and high-sensitivity C-reactive protein in the adult group. Hepcidin levels decreased after dialysis from 532 ± 297 to 292 ± 171 ng/ml. Hepcidin clearance by HD was 141 ± 40 and 128 ± 44 ml/min in pediatric and adult patients, respectively (NS). Conclusions: These findings suggest that hepcidin may mediate the negative effects of inflammation on both disordered iron metabolism and erythropoiesis in HD patients and that intensification of HD could be used therapeutically to reduce hepcidin concentrations and thereby improve erythropoiesis-stimulating agent responsiveness.
UR - http://www.scopus.com/inward/record.url?scp=77953307194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953307194&partnerID=8YFLogxK
U2 - 10.2215/CJN.08161109
DO - 10.2215/CJN.08161109
M3 - Article
C2 - 20299375
AN - SCOPUS:77953307194
VL - 5
SP - 1010
EP - 1014
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
SN - 1555-9041
IS - 6
ER -