Τίτλος:
Assessment of serum bioactive hepcidin-25, soluble transferrin receptor and their ratio in predialysis patients: Correlation with the response to intravenous ferric carboxymaltose
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Drakou, A.
Margeli, A.
Theodorakopoulou, S.
Agrogiannis, I.
Poziopoulos, C.
Papassotiriou, I.
Vlahakos, D.V.
Περιοδικό:
BLOOD CELLS MOLECULES AND DISEASES
Εκδότης:
Academic Press Inc.
Λέξεις-κλειδιά:
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
DOI:
10.1016/j.bcmd.2016.05.006
