Sp605functional Epo-Hepcidin Axis in Recombinant Human Epo Independent Hemodialysis Patient

Touzot, Maxime; Roux, A.; Karim, Zoubida; Maheas, Catherine; Ridel, Christophe; Puy, Hervé; Lefèbvre, Thibaud

doi:10.1093/ndt/gfx153.sp605

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“…Nine out of 15 EPO free patients, as previously described, were enrolled in the study . Causes for exclusion were either patient refusal or kidney transplantation.…”

Section: Resultsmentioning

confidence: 99%

“…We initiated a mono‐center observational prospective pilot study of nine adult hemodialysis patients (>18 years old) referred to as “rHU‐EPO free patients” as described previously . Briefly, the criteria to be considered rHU‐EPO free were: (1) absence of rHU‐EPO administration during the past 6 months, and (2) a stable hemoglobin level within the range (10.5–12 g/dL) as recommended by the KDIGO.…”

Section: Methodsmentioning

confidence: 99%

“…HD patients that have normal hepcidin levels might be responsive to oral iron therapy. We recently reported a cohort of HD patients, referred to as “EPO Free patients,” that appear to have a functional EPO‐hepcidin axis . The latter includes recovery of endogenous EPO production and a rescue of normal levels of serum hepcidin.…”

Section: Introductionmentioning

confidence: 99%

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A hepcidin‐based approach for iron therapy in hemodialysis patients: A pilot study

Touzot

Lefèbvre

Maheas

et al. 2020

Hemodialysis International

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Introduction: Hepcidin is a key factor that regulates iron homeostasis. In hemodialysis patients (HD), a high hepcidin level may decrease intestinal iron absorption and reduce the efficacy of Oral iron vs Intravenous iron therapy. Whether the hepcidin level in HD could guide oral iron therapy is unclear. Methods:We report a monocentric study on nine "erythropoietin (EPO)-free" patients (without recombinant human EPO [rHU-EPO] for at least 6 months) and normal hepcidin level (<20 ng mL) during the study. After 15 days of washout, oral iron (ferrous sulfate 80 mg/day) was introduced. The primary end point was the hemoglobin response and iron store at 3 months.Findings: Nine patients (8 men, 1 woman) with a median age of 62 years (range 42-79) were included. After 1 week of treatment, the median transferrin saturation index increased from 15% (range 6-61) to 34% (range 13-42), P = 0.62, reflecting intestinal absorption. The median ferritin level remained stable 80 μg/L (35-293) vs 82 μg/L (range 37-496) between M0 and M3, P = 0.43. During the 3-month study, median hemoglobin level increased from 11.5 d/dL (range10.4-13.7) to 12.8 g/dL (range 11.1-15.2), P = 0.01.No major side effects were observed. Quality of life assessed by the SF-36 criteria was similar during the 3-month study.Discussion: Oral iron therapy is effective and safe in EPO-free patients with normal hepcidin levels. These findings suggest that serum hepcidin may be a marker for defining iron therapy strategies in HD patients. HD patients treated with rHU-EPO and with normal hepcidin levels could benefit from oral iron treatment.

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“…Nine out of 15 EPO free patients, as previously described, were enrolled in the study . Causes for exclusion were either patient refusal or kidney transplantation.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%