Relationship between serum hepcidin levels and cardiovascular disease in patients with maintenance hemodialysis

Xu, Yan; Y, Wang; Hu, Haofei; Li, J; Tian, T

doi:10.1556/2060.2020.00040

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…8 Previous studies demonstrated that hepcidin-25 could help to evaluate the iron status and anemia, 9,10 and participated in the pathophysiology of atherosclerosis and cardiovascular events in patients receiving MHD. 11,12 However, one study of 56 patients receiving MHD showed that serum hepcidin-25 could not predict the hematopoietic response to the therapy of intravenous iron plus erythropoiesis-stimulating agent (ESA). 13 A similar conclusion was reported in another study of 61 patients with nondialysis chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Serum Hepcidin-25 and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis

Zou¹,

Sun²,

Hua³

et al. 2021

IJGM

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Background: Hepcidin plays an important role in iron homeostasis, inhibits intestinal iron absorption and iron release from hepatocytes and macrophages, while its clinical utility remained unclear. This study aimed to investigate the associations between hepcidin-25 and mortality in MHD patients. Methods: This was a prospective observational cohort of 161 MHD patients, with 2-year follow-up. We investigated the relationships between the variables in our dataset, including serum hepcidin-25, demographic characteristics as well as other clinical parameters. Results: The median value of baseline serum hepcidin-25 was 31.0 (12.1, 57.3) ng/mL; therefore, the patients were stratified into two groups (low-level hepcidin-25 group, and highlevel hepcidin-25 group). The serum iron, serum ferritin, transferrin saturation (TSAT), and hsCRP were higher, pre-dialysis creatinine and albumin were lower, and the scores of healthrelated qualities of life were worse in the high-level hepcidin-25 group than in the low-level hepcidin-25 group. Maximal information-based nonparametric exploration analysis suggested that serum hepcidin-25 was associated with ferritin, TSAT, and all-cause mortality. The patients with hepcidin-25<31 ng/mL had better survival outcomes than those with hepcidin-25≥31 ng/mL during the 24-month follow-up (Log rank test, P = 0.0017). For per 10ng/mL increase of serum hepcidin-25, the hazard ratio (HR) for all-cause mortality was 1.225 (95% confidence interval [CI]1.085-1.382, P<0.001), which remained significant after multivariate adjustments. Conclusion: Serum hepcidin-25 was associated with ferritin and TSAT, and could be an independent predictor for all-cause mortality in MHD patients. Further research with larger sample size and longer-term follow-up is still needed.

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Section: Introductionmentioning

confidence: 99%

Serum Hepcidin-25 and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis

Zou¹,

Sun²,

Hua³

et al. 2021

IJGM

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“…Recent studies have shown that hepcidin, an iron regulator, was associated with absolute and functional iron deficiency [18]. Additionally, hepcidin was associated with high rates of cardiovascular disease or mortality via direct or indirect pathways in patients undergoing dialysis [19][20][21][22]. Iron overload is associated with cellular damage via the generation of reactive oxygen species, which leads to adverse events such as premature death or atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association between Iron Status and Survival in Patients on Chronic Hemodialysis

et al. 2023

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The aim of this study was to evaluate survival rates according to iron status in patients undergoing maintenance hemodialysis (HD). Thus, the National HD Quality Assessment Program dataset and claims data were used for analysis (n = 42,390). The patients were divided into four groups according to their transferrin saturation rate and serum ferritin levels: Group 1 (n = 34,539, normal iron status); Group 2 (n = 4476, absolute iron deficiency); Group 3 (n = 1719, functional iron deficiency); Group 4 (n = 1656, high iron status). Using univariate and multivariable analyses, Group 1 outperformed the three other groups in terms of patient survival. Using univariate analysis, although Group 2 showed a favorable trend in patient survival rates compared with Groups 3 and 4, the statistical significance was weak. Group 3 exhibited similar patient survival rates to Group 4. Using multivariable Cox regression analysis, Group 2 had similar patient survival rates to Group 3. Subgroup analyses according to sex, diabetic status, hemoglobin level ≥ 10 g/dL, and serum albumin levels ≥ 3.5 g/dL indicated similar trends to those of the total cohort. However, subgroup analysis based on patients with a hemoglobin level < 10 g/dL or serum albumin levels < 3.5 g/dL showed a weak statistical significant difference compared with those with hemoglobin level ≥ 10 g/dL, or serum albumin levels ≥ 3.5 g/dL. In addition, the survival difference between Group 4 and other groups was greater in old patients than in young ones. Patients with a normal iron status had the highest survival rates. Patient survival rates were similar or differed only modestly among the groups with abnormal iron status. In addition, most subgroup analyses revealed similar trends to those according to the total cohort. However, subgroup analyses based on age, hemoglobin, or serum albumin levels showed different trends.

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Serum hepcidin levels and cardiovascular outcomes in patients on maintenance hemodialysis

Yadla¹,

Anupama²

2022

Journal of the Egyptian Society of Nephrology and Transplantation

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Background Cardiovascular mortality is high in patients on maintenance hemodialysis. Different factors and plausible mechanisms have been explained for the increased risk. A recent concept of iron dysregulation and the related biomarker serum hepcidin was thought to be one of the novel markers of cardiovascular disease. We undertook this study to study the fatal and nonfatal cardiovascular events in dialysis population. Patients and methods All the patients who satisfied inclusion criteria were included in the study. All the patients have been on either twice-/thrice-weekly dialysis with polysulfone membrane of 1.3-m2 surface area. Serum hepcidin levels were estimated in blood samples using the appropriate techniques. All the patients were followed up for 18 months to assess the fatal and nonfatal cardiovascular outcomes. Results A total of 80 patients satisfied the criteria and were followed up. Mean serum hepcidin levels were 116.3 ± 32 ng/ml. On univariate analysis of factors influencing mortality, age, sex, and presence of comorbidities did not show significant association, but the levels of serum bicarbonate, albumin, creatinine, cholesterol, triglycerides, and the high-sensitivity C-reactive protein, hepcidin, showed a significant association with mortality. Serum hepcidin level of 120 ng/ml predicted mortality with a sensitivity of 100% and specificity of 85%. Conclusions Serum hepcidin is associated with all-cause mortality and cardiovascular mortality in patients on hemodialysis. Hepcidin levels may serve a good predictor of cardiovascular outcomes in patients on hemodialysis.

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Relationship between serum hepcidin levels and cardiovascular disease in patients with maintenance hemodialysis

Cited by 3 publications

References 34 publications

Serum Hepcidin-25 and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis

Serum Hepcidin-25 and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis

Association between Iron Status and Survival in Patients on Chronic Hemodialysis

Serum hepcidin levels and cardiovascular outcomes in patients on maintenance hemodialysis

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