Abstract: SA-PO822

Difference in the Hepcidin/Ferritin Ratio among Non-Dialyzed CKD Patients, and Patients on Hemodialysis and Peritoneal Dialysis

Session Information

Category: Dialysis

  • 605 Dialysis: Anemia and Iron Metabolism

Authors

  • Niikura, Takahito, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Maruyama, Yukio, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Nakashima, Satomi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Matsuo, Nanae, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Tanno, Yudo, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Ohkido, Ichiro, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yokoyama, Keitaro, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yamamoto, Hiroyasu, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
Background

The level of hepcidin, a key mediator of iron homeostasis, generally increases in patients with chronic kidney disease (CKD), attributable to inflammation or a decline in the glomerular filtration rate (GFR). Although the hepcidin/ferritin ratio is used in hepatic disorders (e.g., viral and autoimmune hepatitis) and hematological disease (e.g., hereditary hemochromatosis and thalassemia), its role in renal patients have never been investigated. We evaluated the hepcidin/ferritin ratio in non-dialyzed CKD patients, and in those undergoing hemodialysis (HD) or peritoneal dialysis (PD); we also used this ratio to explore iron homeostasis in CKD patients.

Methods

We recruited 285 CKD patients (117 non-dialyzed CKD patients, 80 HD patients, and 88 PD patients) and measured the levels of serum hepcidin-25, ferritin and markers of kidney disease. Serum hepcidin-25 levels were assessed via liquid chromatography/tandem mass spectrometry.

Results

The serum hepcidin-25 level was elevated in all CKD patients, and was significantly higher in PD than non-dialyzed CKD and HD patients (68.6 [0.4–262] vs. 32.8 [0.7–240] vs. 25.9 [0.4–196] ng/mL, p < 0.01). The serum hepcidin-25 level correlated positively with that of serum ferritin in all CKD patients, whereas the hepcidin/ferritin ratio was higher in PD patients than in other CKD patients.

Conclusion

PD patients exhibited a higher serum hepcidin-25 level and the hepcidin/ferritin ratio than did non-dialyzed CKD and HD patients. Several factors unique to PD patients, such as continuous peritoneal stimulus by the dialysate, and subclinical inflammation and infection, may explain the high hepcidin/ferritin ratio in such patients.