Original Report: Laboratory Investigation

Association of Prohepcidin and Hepcidin-25 with Erythropoietin Response and Ferritin in Hemodialysis Patients
Akihiko Kato^a, Takayuki Tsuji^b, Jinghui Luo^b, Yukitoshi Sakao^b, Hideo Yasuda^b, Akira Hishida<sup>b

a</sup>Division of Blood Purification and
^bFirst Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

Address of Corresponding Author

Am J Nephrol 2008;28:115-121 (DOI: 10.1159/000109968)

  Key Words

• Hepcidin-25
• Prohepcidin
• Erythropoietin hyporesponsiveness
• Iron deficiency, functional
• Hemodialysis, chronic

  Abstract

Hepcidin is a key regulator of iron metabolism. In this study, we examined whether measurement of hepcidin is useful in assessing recombinant human erythropoietin (rHuEPO) responsiveness in regular hemodialysis (HD) patients in a cross-sectional fashion. We examined the association between serum prohepcidin, a prohormone of hepcidin, and rHuEPO dosage and the rHuEPO/hemoglobin (Hb) ratio in 75 HD patients. We also semiquantatively measured the peak intensity of serum hepcidin-25, the major form of mature hepcidin, in 24 HD patients by using surface-enhanced laser desorption ionization time of flight time mass spectrometry, and compared those between rHuEPO-hyporesponsive (rHuEPO 192 ± 10 [126-252] IU/kg/week, n = 15) and responsive patients (rHuEPO 40 ± 9 [0-81] U/kg/week, n = 9). A significant but weak relationship was found between serum prohepcidin and rHuEPO dosage (r = 0.24, p < 0.05) and rHuEPO/Hb ratio (r = 0.22, p = 0.06). However, prohepcidin did not become an indicator of hematopoietic parameters by multiple regression analysis. Serum hepcidin-25 intensity was significantly and positively correlated with ferritin (r = 0.51, p < 0.01) but not with log-transformed C-reactive protein. There was no difference in the intensities of serum hepcidin-25 between rHuEPO-hyporesponsive and responsive patients (64 ± 10 vs. 52 ± 16 AU, p = NS). It follows from these findings that the assessment of serum hepcidin using currently available assays was not valid in predicting rHuEPO responsiveness in chronic HD patients.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Akihiko Kato, MD
Division of Blood Purification
Hamamatsu University School of Medicine
Hamamatsu, Shizuoka 431-3192 (Japan)
Tel./Fax +81 53 435 2756, E-Mail a.kato@hama-med.ac.jp

  Article Information

Received: July 2, 2007
Accepted: August 28, 2007
Published online: October 17, 2007
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 1, Number of References : 27