TY - JOUR
TI - Assessment of serum bioactive hepcidin-25, soluble transferrin receptor and their ratio in predialysis patients: Correlation with the response to intravenous ferric carboxymaltose
AU - Drakou, A.
AU - Margeli, A.
AU - Theodorakopoulou, S.
AU - Agrogiannis, I.
AU - Poziopoulos, C.
AU - Papassotiriou, I.
AU - Vlahakos, D.V.
JO - BLOOD CELLS MOLECULES AND DISEASES
PY - 2016
VL - 59
TODO - null
SP - 100-105
PB - Academic Press Inc.
SN - 1079-9796
TODO - 10.1016/j.bcmd.2016.05.006
TODO - biological marker;  C reactive protein;  ferric carboxymaltose;  hepcidin;  hepcidin 25;  interleukin 6;  transferrin receptor;  unclassified drug;  ferric carboxymaltose;  ferric ion;  hepcidin;  hepcidin 25, human;  maltose;  transferrin receptor, aged;  area under the curve;  Article;  chronic kidney disease;  clinical effectiveness;  controlled study;  correlational study;  diagnostic accuracy;  diagnostic test accuracy study;  dialysis;  disease severity;  drug response;  erythropoiesis;  female;  human;  iron deficiency anemia;  major clinical study;  male;  outcome assessment;  priority journal;  prospective study;  receiver operating characteristic;  sensitivity and specificity;  analogs and derivatives;  blood;  chronic kidney failure;  complication;  dialysis;  drug effects;  drug monitoring;  middle aged;  procedures;  prognosis;  very elderly, Aged;  Aged, 80 and over;  Anemia, Iron-Deficiency;  Dialysis;  Drug Monitoring;  Erythropoiesis;  Female;  Ferric Compounds;  Hepcidins;  Humans;  Male;  Maltose;  Middle Aged;  Prognosis;  Prospective Studies;  Receptors, Transferrin;  Renal Insufficiency, Chronic;  Sensitivity and Specificity
TODO - Background: No reliable biomarker exists to predict responsiveness to intravenous (IV) iron (Fe) in iron deficient patients with CKD. We aimed to investigate the clinical value of bioactive Hepcidin-25 and soluble Transferrin Receptor (sTfR) levels in predialysis patients. Patients and methods: In this prospective study 78 stable stage III-IV CKD predialysis patients with (responders) (40 patients) and without (non-responders) (38 patients) adequate erythropoiesis after IV administration of ferric-carboxymaltose (FCM). Patients were divided in two groups according to their response to IV administration of ferric-carboxymaltose (FCM). Along with measurements of common hematologic and blood chemistry parameters, determinations of sTfR and bioactive Hepcidin-25 were performed.Results: Hepcidin-25 levels were lower in the responders (p = 0.025), while sTfR and sTfR/Hepcidin-25 ratio were higher (p < 0.01 and p = 0.002 respectively). Diagnostic efficacy indicated cut off point of 1.49 for Hepcidin-25 had sensitivity 84% and specificity 48%, while cut off point of 1.21 for sTfR/Hepcidin-25 ratio had sensitivity 82% and specificity 52% to predict correctly response to iron supplementation therapy. Furthermore, log sTfR/Hepcidin-25 correlated negatively with hs-CRP (p = 0.005) and IL-6 (p < 0.04) in non-responders, while such correlations were not found in responders (p > 0.05). Conclusions: These results suggest that lower Hepcidin-25, as well as higher sTfR and sTfR/Hepcidin-25 ratio were significant predictors of favorable hemoglobin response within a month after IV administration of FCM in patients with CKD. Further experiments and clinical studies in other groups of patients are needed to better elucidate the role of Hepcidin-25 and sTfR/Hepcidin-25 ratio as predictors of response to intravenous iron administration. © 2016 Elsevier Inc.
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