Study of Anemia in CKD Patients with Special Reference to Hepcidin

Anemia is a major complication of CKD. The major cause of anemia in CKD is erythropoietin deficiency. But hyporesponsiveness and resistance to ESAs emerging. It has been hypothesized that inflammation may play an important role in anemia of CKD. Although serum ferritin and transferrin saturation (TS...

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Bibliographic Details
Published in:Indian journal of clinical biochemistry 2022-05, Vol.30 (S1), p.S94
Main Authors: Goyal, Himank, Mohanty, Smita, Sharma, Monica, Rani, Anita
Format: Article
Language:English
Subjects:
Analysis
Erythropoietin
Ferritin
Iron deficiency anemia
Kidney diseases
Medical research
Medicine, Experimental
Physiological aspects
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Summary:Anemia is a major complication of CKD. The major cause of anemia in CKD is erythropoietin deficiency. But hyporesponsiveness and resistance to ESAs emerging. It has been hypothesized that inflammation may play an important role in anemia of CKD. Although serum ferritin and transferrin saturation (TSAT) are commonly used as biomarkers for iron status in CKD patients, these markers are not sensitive enough to distinguish functional iron deficiency from iron overload. Recently, Hepcidin, an acute phase reactant protein produced in the liver, is thought to be central regulator of body iron metabolism. We studied anemia in 100 adult non dialysis dependent CKD (Stage 3-5) patients in a hospital based cross sectional study. Hepcidin levels, ferritin levels and hsCRP were elevated in patients of CKD with anemia. Hepcidin levels increased as CKD progressed through stage 3-5 (p trend = 0.015) but did not correlate with estimated glomerular filtration rate. Hepcidin correlated positively with ferritin (p < 0.0001) and % transferrin saturation (p = 0.0217) and negatively with erythropoietin levels (p = 0.0258) but did not correlate with either hsCRP or eGFR. Haemoglobin correlated significantly and positively with eGFR (p < 0.0001). Haemoglobin correlated negatively with ferritin and hepcidin in univariate model, but did not correlate with either of them in multivariate model. Iron status influenced hepcidin levels of patients. We divided patients into different groups according to iron status based on study done by Mercadel et al. we observed that while absolute iron deficiency (TSAT < 20%, Ferritin < 40) is associated with downregulation of hepcidin. Iron status of patients also influences interaction between hepcidin and haemoglobin. Hepcidin correlated negatively in patients with sufficient iron status but nearly correlated positively with haemoglobin in patients with absolute iron deficiency.
ISSN:0970-1915