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ORIGINAL ARTICLE
Year : 2012  |  Volume : 1  |  Issue : 3  |  Page : 126-131

Serum prohepcidin level in children with chronic kidney disease in relation to iron markers


1 Pediatrics' Department, Zagazig University, Cairo, Egypt
2 Clinical Pathology Department, Zagazig University, Cairo, Egypt

Correspondence Address:
Doaa M Youssef
Pediatrics' Department, Zagazig University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0521.106081

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Introduction: It is possible that progressive renal insufficiency leads to altered hepcidin metabolism, subsequently affecting the enteric absorption of iron and the availability of iron stores. Because of the previous absence of an accurate serum assay, most studies of hepcidin in humans have been performed using a urinary assay. We conducted this study to evaluate the level of serum prohepcidin in anemia of chronic kidney disease (CKD) patients, with close analysis of data to different hematological parameters, especially iron markers. Subjects and Methods: This is an analytical cross-sectional case-control study involving: Group I - 20 patients of CKD on hemodialysis, nine males and 11 females, and their age ranged from 8.6 to 17 years; Group II - 10 patients of CKD stage 3 and 4, six females and four males, and their age ranged from 8.1 to 15 years on conservative treatment; and Group III, 10 control participants with normal kidney function, seven males and three females, and their with age ranged from 8 to 16 years. Diseased patients had six patients on intravenous iron supplementation. All participants met the following criteria at the time of sampling: A stable clinical state and no thrombosis or infection, with controlled blood pressure, no more than twice of the normal SGOT and SGPT. All participants were subjected to full medical history, thorough clinical examination and laboratory evaluation (kidney functions, liver functions, C-reactive protein, serum levels of hepcidin prohormone using ELISA, serum levels of iron, ferritin and total iron binding capacity (TIBC), hemoglobin, hematocrit, intact parathormon level (iPTH), serum albumin, serum cholesterol and triglycerides. Results : Our study demonstrated a significant rise in serum prohepcidin levels in the diseased groups, a significant rise in serum ferritin and no significant difference between TIBC and serum iron levels between the diseased groups and the control group. A significant positive correlation was demonstrated between serum prohepcidin levels and serum ferritin, while a significant negative correlation was revealed between serum prohepcidin and hemoglobin, hematocrit and TIBC. We did not find a significant correlation between serum prohepcidin and C reactive protein (CRP) as an inflammatory marker in our patients. No significant difference was detected in prohepcidin levels in the patients who were on intravenous iron therapy in comparison with who were not. Conclusion : We concluded that there is a positive association between serum prohepcidin level and serum ferritin and other conventional markers of iron metabolism in CKD patients.


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