Value of hepcidin in diagnosis and monitoring of iron disorders in patients on regular hemodialysis and its relation to hcv infection.

Introdction:-Anemia is a common complication in maintenance Hemodialysis patients and Recombinant erythropoietin (rhEPO) has transformed anemia therapy in those patients,However, rhEPO resistance, often associated with iron deficiency and inflammation, remains a challenging problem. Current available iron indices do not reliably identify iron-restricted erythropoiesis, a sequel of inflammation, or patients who may benefit from parenteral iron therapy .Hepcidin is a peptide hormone produced by the liver and up regulated in inflammatory conditions, including uremia prevents iron absorption from the gut and release from macrophages and hepatocytes. In hemodialysis patients, serum hepcidin level increases resulting in iron restriction. Hepcidin deficiency with hepatic iron overload can complicate chronic hepatitis C virus (HCV) infection and may worsen prognosis, and iron depletion reported to be beneficial. We aimed to measure the relation between hepcidin level and iron deficiency anemia and HCV in hemodialysis patients. Methods:- Complete blood count , iron, TIBC, Ferritin, Serum creatinine, blood urea, Liver enzymes, CRP, Hepcidin and HCV ab were measured in 30 adult men and women patients on regular hemodialysis having anemia with or without HCV seropositivity and in a control group of 20 healthy adult men and women. Results:-A significant correlation was found between serum hepcidin and Patients’ hemoglobin and iron profile regardless of HCV serology. Conclusion:-In patients on regular hemodialysis,hepcidin level is higher and can be used in diagnosis and monitoring of iron disorders and hepcidin antagonism can be used in the treatment of iron deficiency anemia and rhEPO resistanceregardless of HCV serology. .