• DOI:10.1093/ndt/gfs322
• Corpus ID: 8238114

Serum hepcidin-25 levels predict the progression of renal anemia in patients with non-dialysis chronic kidney disease.

@article{Niihata2012SerumHL,
  title={Serum hepcidin-25 levels predict the progression of renal anemia in patients with non-dialysis chronic kidney disease.},
  author={Kakuya Niihata and Naohisa Tomosugi and Takuya Uehata and Tatsuya Shoji and Kensuke Mitsumoto and Morihiro Shimizu and Hiroaki Kawabata and Yusuke Sakaguchi and Akira Suzuki and Terumasa Hayashi and Noriyuki Okada and Yoshitaka Isaka and Hiromi Rakugi and Yoshiharu Tsubakihara},
  journal={Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association},
  year={2012},
  volume={27 12},
  pages={
          4378-85; discussion 4384-5
        }
}

• Kakuya Niihata, N. Tomosugi, +11 authors Y. Tsubakihara
• Published 1 December 2012
• Medicine, Biology
• Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

BACKGROUND
Hepcidin is associated with iron-restricted erythropoiesis. A previous cross-sectional study showed that serum hepcidin-25 levels are negatively associated with the hemoglobin concentration in non-dialysis chronic kidney disease (CKD) patients with sufficient iron stores. This longitudinal study aimed at ascertaining the association between hepcidin-25 levels and the progression of renal anemia.

METHODS
We selected 335 non-dialysis CKD patients who showed hemoglobin concentrations >10 g/dL and who were not receiving erythropoiesis-stimulating agent (ESA) therapy, from among the subjects of our previous study, who had been recruited between February and June 2007 in a previous study. The primary outcome was the start of the ESA therapy or hemoglobin concentrations remaining below 10 g/dL for >3 months, by 31 December 2010. The patients were classified into high- and low-ferritin groups depending on their median ferritin levels. The Cox proportional hazard model with restricted cubic spline curve analysis was used to determine the association between hepcidin-25 levels and the outcome for each group.

RESULTS
The hepcidin-25 level was a significant predictor both for the high-ferritin group (P = 0.04, linearity = 0.02) and for the low-ferritin group (P = 0.04, linearity P = 0.02). The spline curve for the high-ferritin group showed that higher hepcidin-25 levels had a high log-relative hazard.

CONCLUSIONS
Higher hepcidin-25 levels predict the progression of anemia in non-dialysis CKD patients with sufficient iron stores, indicating the involvement of hepcidin in the progression of anemia in non-dialysis CKD patients.