Role of hepcidin to identify the type of anemia in chronic kidney disease in children

Abstract

Abstract Chronic kidney disease (CKD) may present with anemia of chronic disease (ACD), iron-deficiency anemia, or both (mixed anemia). Common hematologic parameters may not distinguish type of anemia in CKD. Hepcidin is a new variable considered to guide management of anemia in CKD. This study aimed to determine type of anemia in children with CKD, and determine the level of hepcidin in those patients and its relationship with degree of CKD, hemoglobin, and ferritin. This was a cross sectional study in 2-18 years non-dialyzed children with CKD. Subjects were divided into group I (CKD stage 1-2) and group II (CKD stage 3-5). Each group consisted of 29 subjects. Anemia occurred in 34 of 58 subjects, 24 were ACD and 10 were mixed anemia. Median of hepcidin levels in group II were significantly higher than group I (33.4 vs 12.5 ng/mL). Hepcidin has positive correlation with ferritin. ROC analysis showed that hepcidin level of >18 ng/mL may predict ACD. Ferritin level of >99.7 ng/dL can predict hepcidin >18ng/mL (sensitivity 74.2% and specificity 70.4%). This study concluded that ACD is the most type of anemia in CKD besides mixed anemia.