Assessment of serum bioactive hepcidin-25, soluble transferrin receptor and their ratio in predialysis patients: Correlation with the response to intravenous ferric carboxymaltose

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• 作者：Athina Drakou^a ; Alexandra Margeli^b ; Stamatia Theodorakopoulou^a ; Ioannis Agrogiannis^a ; Christos Poziopoulos^b ; Ioannis Papassotiriou^b ; ^{biochem@paidon-agiasofia.gr" class="auth_mail" title="E-mail the corresponding author} ; ^{ipapassotiriou@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Demetrios V. Vlahakos^a
• 关键词：Chronic kidney disease ; Intravenous iron administration ; Hepcidin-25 ; sTfR ; Ferric carboxymaltose
• 刊名：Blood Cells, Molecules and Diseases
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：59
• 期：Complete
• 页码：100-105
• 全文大小：431 K

文摘

No reliable biomarker exists to predict responsiveness to intravenous (IV) iron (Fe) in iron deficient patients with CKD. We aimed to investigate the clinical value of bioactive Hepcidin-25 and soluble Transferrin Receptor (sTfR) levels in predialysis patients.

Patients and methods

In this prospective study 78 stable stage III-IV CKD predialysis patients with (responders) (40 patients) and without (non-responders) (38 patients) adequate erythropoiesis after IV administration of ferric-carboxymaltose (FCM). Patients were divided in two groups according to their response to IV administration of ferric-carboxymaltose (FCM). Along with measurements of common hematologic and blood chemistry parameters, determinations of sTfR and bioactive Hepcidin-25 were performed.

Results: Hepcidin-25 levels were lower in the responders (p = 0.025), while sTfR and sTfR/Hepcidin-25 ratio were higher (p < 0.01 and p = 0.002 respectively). Diagnostic efficacy indicated cut off point of 1.49 for Hepcidin-25 had sensitivity 84% and specificity 48%, while cut off point of 1.21 for sTfR/Hepcidin-25 ratio had sensitivity 82% and specificity 52% to predict correctly response to iron supplementation therapy. Furthermore, log sTfR/Hepcidin-25 correlated negatively with hs-CRP (p = 0.005) and IL-6 (p < 0.04) in non-responders, while such correlations were not found in responders (p > 0.05).

Conclusions

These results suggest that lower Hepcidin-25, as well as higher sTfR and sTfR/Hepcidin-25 ratio were significant predictors of favorable hemoglobin response within a month after IV administration of FCM in patients with CKD. Further experiments and clinical studies in other groups of patients are needed to better elucidate the role of Hepcidin-25 and sTfR/Hepcidin-25 ratio as predictors of response to intravenous iron administration.