Understanding and exploiting hepcidin as an indicator of anemia due to chronic kidney disease

Larson, Derek S.; Coyne, Daniel W.

doi:10.1016/j.krcp.2013.01.001

Cited by 18 publications

(12 citation statements)

References 56 publications

(65 reference statements)

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“…Recently, hepcidin excess has been found to account for impaired dietary iron absorption and reticuloendothelial cell iron blockade in CKD patients [ 24 , 25 ]. Hepcidin is a 25-amino acid hormone synthesized in the liver and secreted into circulation [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Altered Metabolism of Blood Manganese Is Associated with Low Levels of Hemoglobin in Patients with Chronic Kidney Disease

et al. 2017

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Blood manganese (Mn) level has been reported to be higher in patients with anemia or iron deficiency. The purpose of this study was to analyze the relationship between blood Mn level and anemia in patients with chronic kidney disease (CKD). A total of 334 patients with CKD who were not treated with dialysis were included in this study. Blood Mn level and serum markers regarding anemia, renal function, and nutrition were measured and analyzed. Median blood Mn level was 8.30 (interquartile range(IQR): 5.27–11.63) µg/L. Univariate linear regression showed that blood Mn level was correlated with age (β = −0.049, p < 0.001), smoking (β = −1.588, p = 0.009), hypertension (β = −1.470, p = 0.006), serum total iron-binding capacity (TIBC) (β = 0.025, p < 0.001), serum transferrin (β = 0.029, p < 0.001), and estimated glomerular filtration rate (eGFR; β = 0.036, p < 0.001). Results of multiple linear regression analysis showed that beta coefficient of hemoglobin was 0.847 (p < 0.001) for blood Mn level in all participants after controlling for covariates, including gender, age, body mass index, smoking, diabetes, hypertension, and eGFR. Multivariate Poisson regression analysis with robust variance after adjusting for gender, age, smoking, hypertension, diabetes, eGFR, and nutritional markers showed that higher blood Mn level (per 1 µg/L increase) was associated with decreased prevalence of anemia (PR 0.974, 95% CI: 0.957 to 0.992, p = 0.005). Taken together, our results demonstrate that blood Mn level is positively associated with hemoglobin level in CKD patients. This might provide important information in the understanding of the pathogenesis of CKD-related anemia.

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Section: Discussionmentioning

confidence: 99%

Altered Metabolism of Blood Manganese Is Associated with Low Levels of Hemoglobin in Patients with Chronic Kidney Disease

et al. 2017

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“…in contrast, iron deficiency significantly reduces hepcidin synthesis. [29][30][31] Besides, in CKD kidney dysfunction results in decreased hepcidin clearance and consequent hepcidin rise with functional iron deficiency anemia development and inaccessible iron storage. In our study, even though they had similar eGFR levels, RTx recipients had slightly higher hepcidin levels than CKD patients.…”

Section: Ta B L Ementioning

confidence: 99%

Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Oruc

Canpolat

Pehlivan

et al. 2020

Pediatric Transplantation

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Background: Although similar factors play a role in both PTA and anemia in patients with CKD, additional risk factors exist in the pathogenesis of PTA. The present study aimed at comparing anemia and inflammation-related parameters between RTx recipients and CKD patients and elucidating the risk factors of PTA. Methods: This single-centered, cross-sectional study consisted of 68 participants: 48 were in the RTx group and 20 were in the CKD group. The CKD patients were comparable to the RTx recipients in terms of age, gender, and eGFR. Serum levels of EPO, hepcidin, and IL-6 were measured by enzyme-linked immunosorbent assays. The ratio of EPO/Hb was calculated to estimate endogenous EPO resistance. Results: The prevalence of anemia was 46% in the RTx group and 30% in the CKD group (P = .23). RTx recipients had significantly lower Hb (P = .04), higher EPO

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“…High hepcidin levels occur when iron stores are replete or there is significant inflammation ( Fig. 7 ) [ 89 ]. Hepcidin levels increase progressively with severity of CKD, with predialysis CKD patients having a two- to four-fold elevation, and dialysis patients with a six- to nine-fold increase of hepcidin [ 90 ].…”

Section: Hepcidin Modulationmentioning

confidence: 99%

“…(B) Decreased duodenal iron absorption under conditions of high hepcidin levels. Adapted from the article of Larson and Coyne (Kidney Res Clin Pract 32:11–15, 2013) [ 89 ] with original copyright holder’s permission.…”

Section: Figurementioning

confidence: 99%

Treatment of renal anemia: Erythropoiesis stimulating agents and beyond

Biggar

Kim

2017

Kidney Res Clin Pract.

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Anemia, complicating the course of chronic kidney disease, is a significant parameter, whether interpreted as subjective impairment or an objective prognostic marker. Renal anemia is predominantly due to relative erythropoietin (EPO) deficiency. EPO inhibits apoptosis of erythrocyte precursors. Studies using EPO substitution have shown that increasing hemoglobin (Hb) levels up to 10–11 g/dL is associated with clinical improvement. However, it has not been unequivocally proven that further intensification of erythropoiesis stimulating agent (ESA) therapy actually leads to a comprehensive benefit for the patient, especially as ESAs are potentially associated with increased cerebro-cardiovascular events. Recently, new developments offer interesting options not only via stimulating erythropoeisis but also by employing additional mechanisms. The inhibition of activin, a member of the transforming growth factor superfamily, has the potential to correct anemia by stimulating liberation of mature erythrocyte forms and also to mitigate disturbed mineral and bone metabolism as well. Hypoxia-inducible factor prolyl hydroxylase inhibitors also show pleiotropic effects, which are at the focus of present research and have the potential of reducing mortality. However, conventional ESAs offer an extensive body of safety evidence, against which the newer substances should be measured. Carbamylated EPO is devoid of Hb augmenting effects whilst exerting promising tissue protective properties. Additionally, the role of hepcidin antagonists is discussed. An innovative new hemodialysis blood tube system, reducing blood contact with air, conveys a totally different and innocuous option to improve renal anemia by reducing mechanical hemolysis.

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Understanding and exploiting hepcidin as an indicator of anemia due to chronic kidney disease

Cited by 18 publications

References 56 publications

Altered Metabolism of Blood Manganese Is Associated with Low Levels of Hemoglobin in Patients with Chronic Kidney Disease

Altered Metabolism of Blood Manganese Is Associated with Low Levels of Hemoglobin in Patients with Chronic Kidney Disease

Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Treatment of renal anemia: Erythropoiesis stimulating agents and beyond

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