Hepcidin in anaemic geriatric patients with non-dialysis chronic kidney disease (ND-CKD)

PurposeAlthough data respecting prevalence of anemia in elderly non-dialysis chronic kidney disease (ND-CKD) patients are still rare, prevalence is supposed to be high, as CKD and anemia increase with age. Hepcidin is a key regulator of iron homeostasis and elevated serum levels reduce enteral iron resorption, making oral iron substitution ineffective. In this setting, a state of functional iron deficiency may develop in ND-CKD and lead to anaemia due to iron-restricted erythropoiesis. Dependence of hepcidin on glomerular filtration rate (GFR) in younger ND-CKD patients could be shown recently. The present study was intended to analyse the dependence of serum hepcidin levels on GFR in anaemic geriatric patients > 60 years suffering from ND-CKD.MethodsExplorative study; 53 patients were selected among in-patients of geriatric department; selection criteria were: non-dialysis CKD, presence of anemia (< 12 g/dL in women, < 13 g/dL in men); transferrin saturation (TSAT) < 16%, C-reactive protein (CRP) < 5 mg/L. Serum hepcidin was analysed by a commercially available ELISA kit (DRG, Marburg, Germany). Findings were evaluated by statistical means.ResultsData reveal a positive correlation between hepcidin and ferritin (P < 0.001) as well as between TSAT and GFR (P = 0.027) and a negative correlation between hepcidin and GFR (P = 0.035). These findings are of statistical significance at a significance level of 0.05. All analyses are of an explorative nature.ConclusionsAs seen in younger patients, we could show a similar dependence of hepcidin serum levels on GFR in elderly anaemic patients suffering from ND-CKD. This finding underlines the option for intravenous iron supplementation in ND-CKD of the elderly. Randomized studies are needed.