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

Joshua Zaritsky1, Brian Young, He-Jing Wang

  • 1Department of Pediatrics, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA. jzaritsky@mednet.ucla.edu

Clinical Journal of the American Society of Nephrology : CJASN
|May 2, 2009
PubMed

Insights

Serum hepcidin levels are significantly elevated in patients with chronic kidney disease (CKD), correlating with iron status and inflammation. This suggests hepcidin may be a key biomarker for iron regulation and anemia in CKD.

Area of Science:

  • Nephrology
  • Hematology
  • Biochemistry

Background:

  • Hepcidin is a crucial regulator of iron homeostasis.
  • Studying hepcidin in chronic kidney disease (CKD) has been challenging due to a lack of validated assays.
  • Iron dysregulation is common in CKD patients.

Purpose of the Study:

  • To measure bioactive serum hepcidin levels in pediatric and adult patients with varying stages of CKD.
  • To investigate the relationship between serum hepcidin and indicators of anemia, iron status, inflammation, and renal function in CKD patients.

Main Methods:

  • A novel competitive enzyme-linked immunosorbent assay (ELISA) was used to measure serum hepcidin.
  • Study included pediatric and adult CKD patients across stages 2-5 (including those on peritoneal dialysis).
  • Multivariate regression analysis was employed to identify predictors of hepcidin levels.

Main Results:

  • Serum hepcidin was significantly increased in all CKD patient groups compared to controls.
  • In pediatric CKD stages 2-4, only ferritin correlated with hepcidin.
  • In adult CKD stages 2-4, ferritin and soluble transferrin receptor were associated with hepcidin, and GFR was inversely correlated.
  • In pediatric CKD stage 5D, iron saturation and ferritin predicted hepcidin.
  • Across all CKD groups, hepcidin was predicted by ferritin, C-reactive protein, and CKD stage.

Conclusions:

  • Elevated hepcidin is present across the spectrum of CKD.
  • Increased hepcidin may contribute to abnormal iron regulation and erythropoiesis in CKD.
  • Serum hepcidin may serve as a novel biomarker for iron status and erythropoietin resistance in CKD.
Abstract

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