Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey.
Med Sci Monit. 2009 Nov;15(11):CR583-7.
Anemia is a common finding in dialysis patients. Recent evidence has accrued that hepcidin, an iron regulatory peptide, may play a crucial role in the pathophysiology of this condition. This study investigated the effect of erythropoietin (EPO) therapy on serum levels of prohepcidin, the pro-hormone of hepcidin, in patients with end-stage renal disease (ESRD) undergoing chronic dialysis treatment.
MATERIAL/METHODS: A total of 40 ESRD patients with renal anemia receiving either hemodialysis or peritoneal dialysis were included in this study. The patients were randomly allocated to EPO (subcutaneous 2000 microg three times weekly) plus parenteral iron (n=23) or parental iron only (n=17). Serum prohepcidin levels were measured before and at the end of the study.
The two groups were comparable in their demographic and laboratory characteristics. No significant differences were found in hemoglobin, hematocrit, iron store indices, or serum levels of prohepcidin at study entry. Significant increases in both hemoglobin and hematocrit as well as a decrease in serum prohepcidin level were evident in the EPO group at the end of the 6-month follow-up in comparison with their values at study entry compared with the control group (P<0.01).
It is concluded that EPO therapy, besides enhancing erythropoiesis, modulates serum prohepcidin levels in dialysis patients.
贫血是透析患者的常见病症。最近的证据表明，铁调节肽——hepcidin 在这种病症的病理生理学中可能起着至关重要的作用。本研究调查了促红细胞生成素（EPO）治疗对接受慢性透析治疗的终末期肾病（ESRD）患者血清前 hepcidin（hepcidin 的前激素）水平的影响。
材料/方法：本研究共纳入 40 名接受血液透析或腹膜透析的 ESRD 伴肾性贫血患者。这些患者被随机分为 EPO（皮下 2000μg，每周 3 次）+静脉铁剂（n=23）或仅静脉铁剂组（n=17）。在研究开始前和研究结束时测量血清前 hepcidin 水平。
两组在人口统计学和实验室特征方面具有可比性。在研究开始时，血红蛋白、血细胞比容、铁储存指标或血清前 hepcidin 水平无显著差异。与对照组相比，EPO 组在 6 个月的随访结束时，血红蛋白和血细胞比容显著增加，血清前 hepcidin 水平显著降低（P<0.01）。
EPO 治疗除了增强红细胞生成作用外，还能调节透析患者的血清前 hepcidin 水平。
