Anemia prevalence and a possible role of hepcidin in its pathogenesis in kidney allograft recipients
J Malyszko, J Malyszko, M Mysliwiec
Ann Transplant 2009; 14(1): 48-49
Hepcidin is a small defensin-like peptide whose production by hepatocytes is modulated in response to anaemia, hypoxia or inï¬‚ ammation. We studied hepcidin correlations with markers of iron status, erythropoietin therapy and markers of inï¬‚ammation in 100 prevalent kidney allograft recipients-Tx. In addition, prevalence of anaemia and its relation to hepcidin was also assessed. Soluble receptor of transferrin-sTfR hsCRP, TNF alpha, IL-6, prohepcidin and hepcidin were measured using commercially available kits.According to WHO definition, prevalence of anaemia was 28%. In anaemic Tx we found a significantly higher serum creatinine, serum prohepcidin, hepcidin, CRP, TNF alpha, IL-6, ferritin, proteinuria, higher use of rapamycin (n=8), and significantly lower use of CSA, lower CSA concentration, lower cholesterol, lower haemoglobin, lower eGFR (MDRD). Serum prohepcidin correlated significantly with creatinine, GFR, time after transplantation, albumin, hsCRP, IL-6 and TNF alpha, whereas hepcidin-25 correlated with serum iron, ferritin, CRP, IL-6, haemoglobin, TSAT, creatinine, GFR. Multiple regression analysis showed that prohepcidin was independently related only to GFR and ferritin. In multiple regressions analysispredictors of serum hepcidin were eGFR, TSAT and hsCRP explaining 79% of the variation of hepcidin.
Conclusions: Prevalence of anaemia is relatively high in population of kidney allograft recipients and not adequately treated (mainly due to reimbursement regulations). Elevated hepcidin levels in kidney transplant recipients may be due to low grade inï¬‚ammation, frequently encountered in this population and mainly to impaired renal function, but it does not seem to be a major pathogenetic factor of anaemia in this population.
Keywords: Kidney Transplantation