The Changes And Significance Of Hepcidin Level And Iron Metabolism Index In Patients With Renal Anemia

Objective:To investigate the changes and significance of serum hepcidin(Hepc)and iron metabolism indicators in patients with renal anemia.Methods: We selected anemia patients 72 with stage CKD3~5(CKD group)in the Department of Nephrology at the Second Hospital of Hebei Medical University and 30 healthy checkers(control group)from October 2017 to March 2018,and collected the two groups' serum hepcidin,anemia index,iron metabolism index and other relevant clinical indicators to analyze the relationship among renal anemia,iron metabolism and hepcidin,and the level of hepcidin.Results:1.Compared with the control group,the levels of Hepc and serum ferritin(SF)in CKD group increased,and the levels of estimated glomerular filtration rate(eGFR),red blood cell(RBC),hematocrit(HCT),hemoglobin(Hb),serum iron(SI),total iron binding capacity(TIBC)and transferrin saturation(TSAT)decreased.The difference was statistically significant(P<0.05).2.Compared with CKD stage 3 and CKD stage 4,the level of Hepc increased in CKD stage 5,and the levels of RBC,Hb,HCT,SI,TIBC,and TSAT decreased.The difference was statistically significant(P<0.05).3.In CKD group,the levels of RBC,Hb,and HCT decreased in patients with iron deficiency,and the level of hepc was increased,the difference was statistically significant(P<0.05);Hemoglobin was positively correlated with TSAT,SI,and TIBC,and negatively correlated with SF and Hepc(P<0.01);Hepc was negatively correlated with HDL,eGFR,TSAT,RBC,HCT,Hb,TIBC,SI,and positively correlated with iPTH,P,BUN,and Scr(P<0.01).4.The ROC curve evaluated the diagnostic value of Hepc in renal anemia: the area under the curve was 0.969,the sensitivity was 87.3%,and the specificity was 100%,P<0.001.Conclusion:1.In patients with CKD,iron deficiency and anemia increase with worsening renal function.Hepcidin is involved in the development of renal anemia by negatively regulating serum iron.2.Hepcidin can be used as a new indicator to predict the state of iron reserves,combined with traditional iron metabolism indicators to assess renal anemia,thus guiding the treatment of iron supplementation.3.The level of hepcidin was positively correlated with the levels of BUN and Scr,and negatively correlated with the level of eGFR,suggesting that serum hepcidin levels could indirectly reflect the state of renal function.