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Can Serum Gdf-15 be Associated with Functional Iron Deficiency in Hemodialysis Patients?

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Abstract

Functional iron deficiency (FID) incidence is gradually increasing in hemodialysis (HD) patients. Recently, high levels of GDF-15 supressed the iron regulatory protein hepcidin and GDF-15 expression increased in iron-deficient patients. The relationship between FID, GDF-15, and hepcidin is currently unknown. The present study aimed to evaluate the association between GDF-15, hepcidin, and FID in chronic HD patients. Serum GDF-15 and hepcidin concentrations were measured in 105 HD patients and 40 controls. FID is defined as serum ferritin >800 ng/mL, TSAT <25 %, Hb levels <11 g/dL, and reticulocyte haemoglobin content (CHr) <29 pg. Serum GDF-15 and hepcidin levels were increased significantly in HD patients with FID, compared to HD patients without anemia and controls. GDF-15 correlated with ferritin, hepcidin, and CRP in the entire cohort. GDF-15 was related to ferritin and CRP in HD patients with FID. GDF-15 is better diagnostic marker than hepcidin for detection of FID [AUC = 0.982 (0.013) versus AUC = 0.921 (0.027); P = 0.0324]. GDF-15 appears to be a promising tool for detection of FID. High levels of ferritin and CRP correlated with GDF-15. Our results support GDF-15 as a new mediator of FID via hepcidin, chronic inflammation, or unknown pathways.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Nephrology, Dr. A. Y. Ankara Oncology Training and Research Hospital, Mehmet Akif Ersoy Mah. 3. Cadde No: 56 Demetevler Yenimahalle, 06200, Ankara, Turkey

    Hakki Yilmaz

  2. Department of Internal Medicine, School of Medicine, Turgut Ozal University, Ankara, Turkey

    Muzaffer Cakmak

  3. Department of Internal Medicine, Agri State Hospital, Agri, Turkey

    Tahir Darcin

  4. Department of Internal Medicine, Yenimahalle State Hospital, Ankara, Turkey

    Osman Inan

  5. Department of Internal Medicine, Section of Nephrology, School of Medicine, Turgut Ozal University, Ankara, Turkey

    Mukadder Ayse Bilgic, Nuket Bavbek & Ali Akcay

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  1. Hakki Yilmaz
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Correspondence to Hakki Yilmaz.

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Yilmaz, H., Cakmak, M., Darcin, T. et al. Can Serum Gdf-15 be Associated with Functional Iron Deficiency in Hemodialysis Patients?. Indian J Hematol Blood Transfus 32, 221–227 (2016). https://doi.org/10.1007/s12288-015-0551-0

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