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Kidney Int. 2010 Oct;78(8):769-73. doi: 10.1038/ki.2010.254. Epub 2010 Jul 28.

Intra-individual variability in serum hepcidin precludes its use as a marker of iron status in hemodialysis patients.

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1
Department of Pathology and Immunology, Washington University, St Louis, Missouri 63110, USA.

Abstract

An accurate assessment of iron status in dialysis patients is important because both anemia and overtreatment with erythropoiesis-stimulating agents are associated with poor clinical outcomes. We have previously shown that both analytical and intra-individual (biological) variability in serum ferritin limits its utility as a proxy for iron stores in patients in this setting. As hepcidin is a direct regulator of iron status, its measurement might be useful for monitoring patients with iron dysregulation. We assessed short-term intra-individual variation of serum hepcidin in 28 patients with stable chronic kidney disease on hemodialysis. The intra-individual variability for serum hepcidin ranged from 9-79% during an initial 2-week to 12-85% over a 6-week period. The concentration of serum hepcidin was significantly correlated with serum C-reactive protein levels over the 6-week study period. Hence, significant intra-individual variability of hepcidin is likely dependent on short-term fluctuations in the inflammatory state. Thus, our results suggest that short-term measurement of serum hepcidin should not be used to guide clinical decisions regarding management of iron status in chronic hemodialysis patients.

PMID:
20668427
DOI:
10.1038/ki.2010.254
[Indexed for MEDLINE]
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