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Research on the Level of Serum hepcidin and Its Relationship with Related Index of Anemia and Iron Metabolism in Peritoneal Dialysis Patients

Author: WangLei
Tutor: ShiYongBing
School: Suzhou University
Course: Nephrology
Keywords: hepcidin anemia iron metabolism peritoneal dialysis
CLC: R692.5
Type: Master's thesis
Year: 2011
Downloads: 42
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Abstract

Objective: Hepcidin is an anti-bacterial peptide which plays an important role in regulating iron homeostasis in human body. This research is expected to investigate the level of serum hepcidin and its relationship with the related index of anemia and iron metabolism in PD patients.Methods: From June to December 2010, 62 cases of patients treated with maintenance dialysis therapy were enrolled in this study, who were hospitalized in the nephrology department of the Second Affiliated Hospital of Soochow University. The PD treatment group (PD group) was 40 cases, Maintenance hemodialysis treatment group (MHD group) was 22 cases, 15 cases of healthy controls were also enrolled. The age and gender among the three groups were matched. Serum hepcidin and interleukin-6 levels were tested by enzyme-linked immunosorbent assay (ELISA). Fasting venous blood samples were extracted to detect the related index of routine blood test, blood biochemistry, electrolyte, anemia and et al. The Kt/V per week was calculated in the PD treatment group. The erythropoietin resistance index was calculated. All statistical analysis were performed with SPSS13. 0. P<0.05 was considered statistically significant.Results: 1. Compared with normal controls, PD group and MHD group had higher serum hepcidin and IL-6 (P<0.05). The levels of serum hepcidin and IL-6 had no significant difference (P >0.05).2. In PD group, serum hepcidin levels were positively correlated with serum ferritin (r=0.422,P=0.007)、serum iron (r=0.403,P=0.010)、interleukin-6 (r=0.319,P=0.045), but negatively correlated with serum transferrin receptor (r=-0.343,P=0.030). Multiple linear stepwise regression analysis showed that Fer (β=0.331, P=0.031) and Fe (β=0.303, P=0.048) were obvious correlating factors to hepcidin.3. According to the value of Kt/V, we divided patients into two groups, there are patients with and without adequacy dialysis. The patients with adequancy dialysis had higher ferritin(P<0.05). The levels of hemoglobin, serum hepcidin , IL-6 and other related index of iron metabolism had no significant difference in the two groups (P>0.05).4. According to the therapy of EPO and iron in the last month before hospitalization, we divided patients into three groups treated with EPO alone, iron alone and the combination of them. We found that the levels of hemoglobin and serum hepcidin was lower in the group treated EPO only compared to the group treated with EPO and iron. The difference had significant (P <0.05).5. In the patients treated with EPO,the erythropoietin resistance index was positively correlated with serum hepcidin (r=0.410,P=0.014) and IL-6(r=0.400,P=0.017). Multiple linear stepwise regression analysis showed that hepcidin (β=0.410, P=0.014) was obvious correlating factor to ERI.Conclusion: 1. ESRD patients generally have higher serum hepcidin level. The effects of different patterns of dialysis on serum hepcidin level had no significant.2. Hepcidin can reflect the iron status in human body. It may attend the development of functional iron deficiency and EPO resistance in peritoneal patients.3. As a new marker, hepcidin can be used as a reflection of anemia in peritoneal patients, it can be helpful to give a new way to treat renal anemia.

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