Elevated Hepcidin Linked to Low Erythropoietin Levels

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Elevated Hepcidin Linked to Low Erythropoietin Levels
Elevated Hepcidin Linked to Low Erythropoietin Levels

This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • High levels of circulating hepcidin are associated with low erythropoietin levels in patients with CKD.
  • Elevated hepcidin may be due in part to EPO deficiency.
  • Failure to reduce hepcidin levels could indicate insufficient EPO replacement.

High levels of circulating hepcidin are associated with low erythropoietin (EPO) levels in patients with CKD, data show. Elevated hepcidin may be due in part to EPO deficiency.

Hepcidin, a hormone made in the liver, inhibits iron absorption and recycling. Elevated plasma levels of this hormone have been found in CKD patients and may contribute to anemia and EPO resistance, the authors noted in a poster at the American Society of Nephrology's Renal Week 2009 in San Diego. The mechanism underlying increases in hepcidin is unknown, but reduced renal clearance would be expected, they noted.

Using a recently developed radioimmunoassay, a team led by Damien Ashby, MD, of Imperial College Kidney and Transplant Institute, Hammersmith Hospital, London, measured plasma hepcidin in 59 stable CKD patients who were not receiving EPO treatment.

The investigators observed elevated hepcidin levels in proportion to the degree of renal impairment. Nevertheless, the relationship between hepcidin and ferritin was preserved.

Moreover, elevated hepcidin was closely associated with low EPO levels. In a multivariate analysis, ferritin, EPO, and glomerular filtration rate independently predicted hepcidin levels. Therefore, EPO deficiency may contribute to increases in hepcidin levels, the authors wrote.

“Failure to reduce hepcidin levels could indicate insufficient EPO replacement,” they concluded.

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