The Role of Hepcidin in Iron Homeostasis and Anemia in Hemodialysis Patients
- 1 January 2009
- journal article
- review article
- Published by Wiley in Seminars in Dialysis
- Vol. 22 (1), 70-77
- https://doi.org/10.1111/j.1525-139x.2008.00532.x
Abstract
Anemia is a common complication in hemodialysis (HD) patients. Despite the great success of recombinant human erythropoietin in clinical practice, resistance to this therapy is common. Additionally, nephrologists frequently witness a rapid and significant drop in their patients' hematocrit during the course of various acute events that regularly take place in this sensitive population. Hepcidin, a recently identified peptide, may mediate this development in many instances. Hepcidin production is regulated by hypoxia/anemia, iron status, and importantly, inflammation. This peptide can block iron absorption by the duodenum, iron release from both the liver (the main iron storage pool) and, more significantly, the macrophages interrupting iron recycling between senescent red cells and the reticuloendothelial system. The decreased availability of iron for erythropoiesis leads to the anemia of chronic disease or, in HD patients, aggravate an already existing anemia HD is now widely considered an inflammatory state probably accounting for the increased serum hepcidin levels that have been associated with it. The physiology of hepcidin and its possible contribution to the pathogenesis of anemia in HD patients are the subject of this review.Keywords
This publication has 86 references indexed in Scilit:
- Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failureNature Clinical Practice Nephrology, 2008
- Dorsomorphin inhibits BMP signals required for embryogenesis and iron metabolismNature Chemical Biology, 2007
- The distal location of the iron responsive region of the hepcidin promoterBlood, 2007
- Posttranslational processing of hepcidin in human hepatocytes is mediated by the prohormone convertase furinBlood Cells, Molecules, and Diseases, 2007
- Regulation of iron homeostasis by the hypoxia-inducible transcription factors (HIFs)JCI Insight, 2007
- The Molecular Mechanism of Hepcidin-mediated Ferroportin Down-RegulationMolecular Biology of the Cell, 2007
- Interleukin-6 induces hepcidin expression through STAT3Blood, 2006
- PLEIOTROPIC EFFECTS OF STATINSAnnual Review of Pharmacology and Toxicology, 2005
- Influence of dialysis with polyamide vs haemophan haemodialysis on monokines and complement activation during a 4-month long-term studyNephrology Dialysis Transplantation, 1999
- Gene expression of interleukin-1β during hemodialysisKidney International, 1993