| Objectives:The purpose of this research is to determine the expression of Hepcidin in the serum of patients with chronic kidney disease(chronic kidney disease,CKD),and analyze the correlation of Hepcidin with renal anemia,iron metabolism,inflammatory status,bone metabolism,erythropoietin(EPO),Glomerular filtration rate(GFR).So it could explore the hepcidin's application value and clinical significance in renal anemia patients' diagnosis and treatment preliminarily.Methods:1.The subjects were divided into maintenance hemodialysis group(Maintenance hemodialysis,MHD)(MHD group)of 30 cases,non-dialysis chronic kidney disease Group(non-dialysis CKD group)of 30 cases,and healthy control group of 20 cases.2.The research collected the morning fasting venous blood samples of patients before treatment and healthy control group respectively.And then sent them to our laboratory to test hemoglobin(HB),ren blood cell specific volume(HCT),mean hemoglobin(mean corpuscular).Hemoglobin,MCH,erythrocyte mean corpuscular volume(MCV),mean corpuscular hemoglobin concentration(MCHC).And the others were sent to the biochemical Immunology laboratory to check blood urea nitrogen(BUN),serum creatinine SCr),uricacid(UA),sodium(Na),potassium(K),calcium(Ca),chlorine(CL),phosphorous(P),albumin(albumin,ALB),prealbumin(PA),aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),serum iron(SI)),serum ferritin(SF),parathormone,PTH),high sensitivity C-reactive protein(hsCRP),interleukin-6(IL-6),cystatin c(CysC),EPO.The enzyme-linked immunosorbent assay(ELISA)method was used to detect the concentration of Hepcidin in the serum.At the same time,the general data which includes gender,age,primary disease,height and weight of the subjects were collected.The research also collected the erythropoiesis stimulater agent(ESA)usage,iron supplementation and other medication data for every week during the research period.3.Pearson correlation analysis was used to analyze the relationship among Hepcidin and HB,BUN,SCr,SI,SF,PTH,hsCRP,IL-6,and stepwise multiple linear regression analysis was used to analyze the related influencing factors of Hepcidin.Single-factor complete random variance analysis was used to compare the differences in three groups of hepcidin.The difference between Hepcidin and HB in the low ferritin and high ferritin groups was analyzed by using an independent t-test.Results:1.The levels of Hepcidin in the MHD group,non-dialysis CKD group,and healthy control group were(88.29±35.79)ng/ml,(72.58±24.24)ng/ml,(14.83±8.51)ng/ml,respectively.The different levels of Hepcidin in these three groups shows a statistical significance(P=0.045).2.According to the research Hepcidin was positively correlated wit h age,MCH,IL-6,SI,SF,ESA/week,(r=0.363,0.415,0.186,0.294,0.785,0.333),and it was negatively correlated with HB,RBC,HCT,EP O(r=-0.179,-0.282,-0.114,-0.332),which the correlation P value was less than 0.05.When P value was less than 0.1,multiple linear regression analysis was performed,EPO and IL-6 is the most closely related t o Hepcidin(P=0.013,0.022).3.Using serum ferritin 100ng/ml as truncation value,the study divided serum ferritin into low ferritin group and high ferritin group.The difference between the two groups in the level of hepcidin showed a statistically significant(P=0.001).There was no statistically significant difference in the levels of HB between the two groups(P=0.827).There had a positive correlation between hepcidin and HB in the low-ferritin group(r=0.196,P=0.04).It also showed a negative correlation between hepcidin and HB in the high-ferritin group(r=-0.222,P=0.037).Conclusion:1.Hepcidin could reflect the inflammatory state and iron status of chronic kidney disease;2.Hepcidin may participate in the development of renal anemia through multiple pathways;3.Hepcidin could be used as a target molecule for the treatment of renal anemia... |
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