Abstract: FR-PO0229
Effect of Extended-Hours Hemodialysis on Hepcidin-25 and Iron Metabolism
Session Information
- Anemia and Iron Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Nishibori, Nobuhiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Okazaki, Masaki, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Imaizumi, Takahiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Yamada, Takumi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Kaneda, Fumika, Iryo Hojin Kamome Clinic, Iwaki, Fukushima Prefecture, Japan
- Kasuga, Hirotake, Nagoya Kyoritsu Byoin, Nagoya, Aichi Prefecture, Japan
- Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
Background
In patients on maintenance hemodialysis (HD), elevated interleukin 6 (IL-6) levels due to chronic inflammation promote hepcidin synthesis and cause anemia due to impaired iron utilization. Extended-hours HD is known to reduce erythropoietin dose, but the mechanism is unknown. The aim of this study is to investigate the impact of extended-hours HD on hepcidin and iron metabolism.
Methods
Patients on extended-hours or conventional HD between January and March 2020 were included, and hepcidin-25 and IL-6 levels were measured in pre-dialysis samples. Multivariable linear regression were performed to investigate the impact of extended-hours HD on hepcidin-25 and ferritin levels. In addition, mediation analysis were performed using hepcidin-25 as mediator to assess the association between extended-hours HD and ferritin levels.
Results
A total of 380 participants (183 on extended-hours HD and 197 on conventional HD) were included in the analysis. The mean of age (years), hemoglobin (g/dL), and ferritin (ng/dL) levels was 66, 10.9 and 51.7 in extended-hours HD group, and 72, 11.2 and 90.9 in conventional HD group. Figure A&B indicated that weekly ESAs dose and hepcidin-25 levels were lower in extended-hours HD grop. Figure C indicated that extended-hours HD was associated with lower hepcidin-25 levels, regardless of IL-6 levels. Multivariable linear regression analysis showed that extended-hours HD was associated with lower hepcidin-25 levels; -15.6 ng/mL (95% confidence interval (CI); -22.9 to -8.4), and lower ferritin levels; -35.7 ng/dL (95% CI; -55.14 to -16.2). By mediation analysis, the proportion of mediating effect of hepcidin-25 was 68.0%, and mediation effect was statistically significant.
Conclusion
Extended-hours HD was associated with lower hepcidin-25 levels, which significantly mediated lower ferritin levels. These changes in iron metabolism may contribute to better clinical outcomes in patients on extended-hours HD.