TY - JOUR
T1 - Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients
AU - Belo, Luís
AU - Rocha, Susana
AU - Valente, Maria João
AU - Coimbra, Susana
AU - Catarino, Cristina
AU - Bronze-da-Rocha, Elsa
AU - Rocha-Pereira, Petronila
AU - Sameiro-Faria, Maria do
AU - Oliveira, José Gerardo
AU - Madureira, José
AU - Fernandes, João Carlos
AU - Miranda, Vasco
AU - Santos-Silva, Alice
N1 - Funding Information:
This work was supported by the Applied Molecular Biosciences Unit (UCIBIO), which is financed by national funds from FCT/MCTES [UID/MULTI/04378/2019] and North Portugal Regional Coordination and Development Commission [CCDR-N]/NORTE2020/Portugal 2020 [Norte-01–0145-FEDER-000024]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Part of the manuscript has been presented in poster format at the 55th ERA-EDTA Congress, 24–27 May 2018, Copenhagen, Denmark, and the abstract was published in the official journal of the Congress [48].
Publisher Copyright:
© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Soluble transferrin receptor (sTfR) is a biomarker of erythropoiesis, which is often impaired in dialysis patients. The aim of our study was to evaluate sTfR levels in chronically dialyzed patients and assess potential determinants of its levels. Methods: We performed a cross-sectional study by evaluating 246 end-stage renal disease patients undergoing dialysis and 32 healthy controls. Circulating levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, hepcidin, sTfR, growth differentiation factor 15 (GDF15), and traditional iron metabolism markers were measured, as well as hemogram parameters. Clinical data was obtained from all patients. Results: Compared to controls, patients presented similar values of sTfR, reticulocytes and reticulocyte production index (RPI), and significantly higher levels of IL-6, CRP, ferritin, hepcidin, TNF-α, and GDF15. Iron, transferrin, hemoglobin levels, erythrocyte count, mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) values were significantly lower in dialysis group. Within patients, sTfR values were higher in diabetic patients and were positively and significantly correlated with reticulocytes and erythrocytes, RPI, and therapeutic doses of erythropoiesis stimulating agents (ESA) and intravenous iron; and inversely and significantly correlated with circulating iron, ferritin, transferrin saturation, hepcidin, MCH, and MCHC. In multiple linear regression analysis, ESA dose, RPI, serum iron, diabetes, and hepcidin levels were independently associated with sTfR levels in dialysis patients and, thus, with erythropoiesis. Conclusion: Our data suggest that, besides RPI and ESA dose, diabetes and hepcidin are closely related to erythropoiesis in dialysis patients. The influence of diabetes on sTfR levels deserves further investigation.
AB - Background: Soluble transferrin receptor (sTfR) is a biomarker of erythropoiesis, which is often impaired in dialysis patients. The aim of our study was to evaluate sTfR levels in chronically dialyzed patients and assess potential determinants of its levels. Methods: We performed a cross-sectional study by evaluating 246 end-stage renal disease patients undergoing dialysis and 32 healthy controls. Circulating levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, hepcidin, sTfR, growth differentiation factor 15 (GDF15), and traditional iron metabolism markers were measured, as well as hemogram parameters. Clinical data was obtained from all patients. Results: Compared to controls, patients presented similar values of sTfR, reticulocytes and reticulocyte production index (RPI), and significantly higher levels of IL-6, CRP, ferritin, hepcidin, TNF-α, and GDF15. Iron, transferrin, hemoglobin levels, erythrocyte count, mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) values were significantly lower in dialysis group. Within patients, sTfR values were higher in diabetic patients and were positively and significantly correlated with reticulocytes and erythrocytes, RPI, and therapeutic doses of erythropoiesis stimulating agents (ESA) and intravenous iron; and inversely and significantly correlated with circulating iron, ferritin, transferrin saturation, hepcidin, MCH, and MCHC. In multiple linear regression analysis, ESA dose, RPI, serum iron, diabetes, and hepcidin levels were independently associated with sTfR levels in dialysis patients and, thus, with erythropoiesis. Conclusion: Our data suggest that, besides RPI and ESA dose, diabetes and hepcidin are closely related to erythropoiesis in dialysis patients. The influence of diabetes on sTfR levels deserves further investigation.
KW - End-stage renal disease
KW - Erythropoiesis
KW - Hepcidin
KW - Iron
KW - Soluble transferrin receptor
UR - http://www.scopus.com/inward/record.url?scp=85070480055&partnerID=8YFLogxK
U2 - 10.1080/0886022X.2019.1635893
DO - 10.1080/0886022X.2019.1635893
M3 - Article
C2 - 31296086
AN - SCOPUS:85070480055
SN - 0886-022X
VL - 41
SP - 662
EP - 672
JO - Renal Failure
JF - Renal Failure
IS - 1
ER -
