Interaction between Serum Prohepcidin, Anemia and Chronic Hepatitis in Hemodialyzed Patients
نویسندگان
چکیده
Background and Aim: Anemia is a major clinical multifactorial problem in hemodialysis (HD) patients. Iron metabolism is frequently impaired and may complicate the management of anemia. Hepcidin is synthesized in the liver. It is thought to be a key regulator of iron homeostasis. Therefore, we thought to assess prohepcidin level and iron indices in patients on regular HD with and without associated viral hepatitis. Patients and Methods: Sixty patients (38 males and 22 females) with chronic renal failure (CRF) undergoing regular HD and twenty age and sex matched healthy controls were included. Peripheral hemogram, liver function tests, kidney function tests, lipogram, C-reactive protein, iron indices, serum prohepcidin, HBsAg, HBcIgM and anti-HCV antibody were tested for both patients and controls. Results: 22 Patients were positive for anti-HCV, 16 were HBsAg positive and 22 were negative for both markers. Mean serum prohepcidin and ferritin levels in HD patients were significantly higher than controls. There was significant increase in the mean serum prohepcidin level in HD patients with hepatitis B compared to those with hepatitis C. Prohepcidin had significant negative correlations with both hemoglobin level and total iron binding capacity in HD patients with hepatitis C. However, in multiple regression analysis, serum prohepcidin level was independently related to hepatitis, and triglycerides level in the whole group of HD patients. Conclusion: CRF patients on HD have elevated serum prohepcidin and hepatitis C patients have higher levels than those with hepatitis B. Prohepcidin was independently related to the presence of viral hepatitis and triglycerides suggesting the important role of the liver in hepcidin synthesis.
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