대한신장학회

논문분류	춘계학술대회 초록집
제목	Association of hepcidin with anemia management in incident dialysis patients: is HD and PD different?
저자	Jeong-hoon LIM1,2, Sang mi PARK1,2, Jeong-hoon LIM1, Jung hwa PARK1,2, Kyung hee LEE1,2, Eun song LEE1,2, Kyu yeun KIM1,2, Hee-yeon JUNG1,2, Jiyoung CHOI1,2, Jang-hee CHO1,2, Chan-duck KIM1,2, Sun-hee PARK1,2, *Yonglim KIM1,2
출판정보	2017; 2017(1):
키워드	ESRD; hemoglobin; hepcidin; incident dialysis; iron parameters; urine volume
초록	Objectives: Regarding anemia management in chronic kidney disease, there are still no absolute parameters which can effectively reflect iron metabolism and erythropoiesis. Hepcidin has been considered to be a key regulator of iron homeostasis in recent years, however, its relationships to other variables are not yet well understood. This study aimed to evaluate association of serum hepcidin level with iron parameters and other clinical parameters in end-stage renal disease (ESRD) patients. Methods: A total of 110 incident dialysis patients were enrolled from a multicenter prospective cohort study. All patients, 68 on peritoneal dialysis (PD) and 42 on hemodialysis (HD), were prospectively followed up for 6 months. Serum hepcidin level was measured by a commercial ELISA kit (DRG Instruments, Marburg, Germany). The relations of hepcidin at baseline and 6 months to clinical parameters were investigated using linear regression models. Results: Hecidin levels significantly increased after 6 months dialysis in both PD and HD groups compared to baseline (Δ hepcidin 26.8 ± 39.6, P<0.001 and 22.9 ± 43.8, P=0.002, respectively). PD group showed higher hemoglobin after 6 months dialysis than HD group (10.7 ± 1.3 vs. 10.0 ± 1.0 g/dL, respectively, P<0.001) in spite of less use of erythropoiesis-stimulating agents during study period (CERA dose: 4.0 ± 2.8 vs. 5.3 ± 2.4 mcg/kg/month, respectively, P<0.013), while hepcidin was significantly higher in PD group than HD group at 6 month follow-up (113.8 ± 27.6 vs. 101.7 vs. 24.4 ng/ml, respectively, P<0.021). A positive correlation was found between serum hepcidin and ferritin in incident ESRD patients and after 6 months dialysis irrespective of dialysis modality. Of note, there was a negative correlation between serum hepcidin level and urine volume in incident ESRD patients at baseline and PD patients at 6 months (both P<0.05). The same tendency was observed in HD patients (P=0.060). Conclusions: Serum hepcidin level increased in both incident PD and HD patients. Hepcidin level is closely related to serum iron parameters. It is important to preserve urine volume in ESRD patients to reduce serum hepcidin level.
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