Investigated The Relationship Of Serum Hepcidin Between Residual Renal Function And Micro-inflammation In Peritoneal Dialysis Patients

Objective:Hepcidin is closely related to the renal anemia, which plays an important role inregulating iron homeostasis in human body. This research is expected to investigatethe level of serum hepcidin and its the relationship of serum hepcidin with residualrenal function,micro-inflammation and dialysis adequacy in continuous ambulatoryperitoneal dialysis(CAPD) patients.Methods:1.From January to June2012,34cases of patients treated with CAPD were enrolled inthis study,who have been dialyzed more than three months and accompanied byanemia,as observation group.In addition,20cases of Chronic kidney disease（CKD）5Phase patients without dialysis were enrolled in this study,which also accompanied byanemia,as control group.All of these patients were hospitalized in the nephrologydepartment of the General Hospital of Ningxia Medical University.The age andgender among the two groups were matched.2.Collecting the general informations of patients,includingage,gender,height,weight,protopathy,dialysis duration,urine output and so on.3.High sensitivity C-reactive protein (Hs-CRP) were represented micro-inflammatorystate.24-hour urine volume less than100ml defined as no residual renal function.4.Dialysis adequacy assessment was calculated by weekly urea clearance index (Kt/V)in CAPD group.5.Serum hepcidin and total iron binding capacity (TIBC) levels were tested by enzyme-linked immunosorbent assay (ELISA).Fasting venous blood samples wereextracted to detect the related index of routine blood test,bloodbiochemistry,ferritin,transferrin,Hs-CRP and et al.5.Patient’s glomerular filtration rate (GFR) was assessed by MDRD formula.6.Participants were grouped:①According to the level of Hs-CRP,34CAPD patientswere divided into2subgroups:High Hs-CRP(Hs-CRP>3.00mg/L,n=14),normalHs-CRP(Hs-CRP≤3.00mg/L,n=20).②On the basis of the24-hour urinevolume,CAPD group were divided into a residual renal function (24-hour urine output＞100ml,n=20),no residual renal function group(24-hour urine output≤100ml,n=14).③In the light of urea clearance index(Kt/V),34CAPD patients weredivided into other2subgroups: adequacy dialysis group(Kt/V≥1.7,n=21),inadequacygroup(Kt/V<1.7,n=13).7.ALL statistical analysis were performed with SPSS17.0.Measurement data using themean plus or minus standard deviation (x±s),count data using the Fisherprobabilities in2*2table test.Between the two groups of continuous variables werecompared using two independent samples t-test.Applying the Pearson correlationanalysis the relationship between hepcidin and other clinical indicators.Multipleregression analysis hepcidin significant predictors.P<0.05was considered statisticallysignificant.Results:1.Compared with control group,serum hepcidin was significantly higher in CAPDpatients【(14.04±7.38)ug/L vs (10.22±4.37)ug/L】.The levels of Hs-CRP had nosignificant difference (P>0.05).2.Serum hepcidin levels of no residual renal function group patients increased moresignificantly in CAPD 【(17.34±5.73)ug/L vs(11.74±7.65)ug/L,P<0.05)】.Furthermore,serum hepcidin levels was high in Hs-CRP elevated group than Hs-CRP normal group 【(21.43±5.57) ug/L vs (8.87±2.25)ug/L,P<0.05】.In Hs-CRP elevated group,the incidence of anuria was significantlyhigher than Hs-CRP normal group(64.29%vs35.71%,P<0.05).3.According to the value of Kt/V, we divided CAPD patients into two subgroups,thereare patients with and without adequacy dialysis. The levels of serum hepcidin hadno significant difference in the two groups【(14.80±6.58)ug/L vs (14.00±7.06)ug/L,P>0.05)】.4.Pearson correlation analyses revealed that serum hepcidin was positively correlatedwith Hs-CRP (r=0.501,P=0.000) and FER (r=0.847,P=0.000),and was negativelycorrelated with HGB (r=-0.919,P=0.000),RBC(r=-0.513,P=0.002),HCT(r=-0.644,P=0.000),TRF(r=-0.751,P=0.000),and TIBC(r=-0.532,P=0.001).5.Linear regression analysis showed that ferritin (Standardized regression coefficient==0.205,P=0.045)and Hs-CRP (Standardized regression coefficient=0.284,P=0.013)were closely associated with serum hepcidin level in CAPD.Conclusion:1.Serum hepcidin levels are markedly elevated in CAPD patients,especially in noresidual renal function patients. Suggesting that the residual renal function may playan important role on serum hepcidin in CAPD patients.2.Serum hepcidin levels in CAPD patients increased more significantly,whenHs-CRP>3.00mg/L.Suggesting that micro-inflammation can stimulate hepcidinmRNA up-regulation.3.Micro-inflammation was closely related with residual renal function in CAPDpatients.4.Hepcidin involved in the regulation of iron metabolism and erythropoietin in CAPDpatients.