透析患者のフェリチン充足下におけるEPO反応性の検討

書誌事項

タイトル別名
  • EPO responsiveness in hemodialysis patients with excessive ferritin

抄録

ESA responsiveness in hemodialysis patients is influenced by various factors such as inflammation, secondary hyperparathyroidism and nutrition. Recently, hepcidin-25, a key regulator of iron homeostasis, was shown to be involved in the pathogenesis of low ESA responsiveness. However, the precise mechanisms of ESA responsiveness remain to be fully elucidated. We examined the relationship between ESA responsiveness and the various clinical parameters of hemodialysis patients with sufficient iron stores (ferritin over 100ng/mL). Twenty-nine hemodialysis patients under epoetin beta (EPO) treatment were divided into two groups, Hb-Low (Hb less than 10g/dL) and Hb-High (Hb more than 10g/dL) groups, and their hematological parameters, the status of iron metabolism and inflammatory markers were compared. Hepcidin-25 and ferritin of the Hb-Low group were significantly higher than those of the Hb-High group (Hb-Low vs. Hb-High, hepcidin-25: 74.7±48.8 vs. 40.1±24.5ng/mL, p=0.018; ferritin: 257±148 vs. 140±61ng/mL, p=0.007). CRP tended to be higher in the Hb-Low group compared to Hb-High group (0.41±0.55 vs. 0.14±0.23mg/dL, respectively, p=0.074), and there was a negative correlation between CRP and Hb in the Hb-Low group. Although the reticulocyte count tended to be higher in the Hb-Low group compared to Hb-High group, this led to no improvement in Hb (Hb: 9.4±0.6 vs. 10.5±0.5g/dL, p<0.001; RET‰: 12.9±4.5 vs. 9.9±4.2‰, p=0.083, respectively). Our data suggest that, in hemodialysis patients presenting with low hemoglobin and sufficient iron stores, high ferritin and a high hepcidin-25 concentration might induce defective iron utilization. In addition, from the tendencies of high CRP and high reticulocytes, a shortened erythrocyte lifespan and micro-inflammation might exist in these patients. The combined impact of these factors may contribute to the low ESA responsiveness.

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詳細情報 詳細情報について

  • CRID
    1390282679656688384
  • NII論文ID
    130002145647
  • DOI
    10.4009/jsdt.45.163
  • ISSN
    1883082X
    13403451
  • データソース種別
    • JaLC
    • Crossref
    • CiNii Articles
  • 抄録ライセンスフラグ
    使用不可

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