C-reactive Protein and Hepcidin in Non-Dialysis Chronic Kidney Disease

Edward Muliawan Putera, W. Widodo, N. Mardiana
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Abstract

Complications such as anemia and its clinical consequences arise as chronic kidney diseases progress,. One renal anemia pathophysiology is a disruption of iron metabolism, regulated by the main iron exporter hormone, hepcidin. Chronic kidney disease patients were constantly in an inflammatory state, represented by an increased in C-reactive protein. This inflammatory state would facilitate the liver to secrete hepcidin, which would subsequently follow a decrease of iron circulation, thus resulting in functional iron deficiency. Both acute phase reactants which used thoroughly as markers in tropical and infectious diseases, had their own roles in chronic kidney disease. The correlation of c-reactive protein and hepcidin in chronic kidney disease patients was still controversial. To analyse the relationship between c-reactive protein and hepcidin in non-dialysis chronic kidney disease patients. We conducted an observational cross-sectional study with 40 non-dialysis chronic kidney disease patients who met the inclusion and exclusion criteria. Patients were enrolled with consecutive sampling and were examined for serum c-reactive protein and hepcidin levels.A total of forty subjects (67.5% male with mean age of 50.23 ± 1.04 years) were eligible for enrolment in this study. The most comorbid factor was hypertension (62.5%). The common stage for chronic kidney disease was stage 3 (40%). The mean hemoglobin value was  10.74 ± 0.36 g/dL, mean blood urea nitrogen was 39.98 ± 29.59 mg/dL, and serum creatinine of 4.12 ± 3.39 mg/dL. Mean serum c-reactive protein levels were 3.52 ± 5.13 mg/l. Mean hepcidin level were 94,03 ± 95,39 ng/ml. Serum C-reactive protein levels correlated positively (r=0.487) and significantly (p-value=0.001) with serum hepcidin value. C-reactive protein and hepcidin was significantly correlated in non-dialysis chronic kidney disease patients.
非透析慢性肾脏疾病中的c反应蛋白和Hepcidin
随着慢性肾脏疾病的进展,贫血等并发症及其临床后果也会出现。肾性贫血的病理生理之一是铁代谢的中断,由主要的铁输出激素hepcidin调节。慢性肾病患者持续处于炎症状态,表现为c反应蛋白升高。这种炎症状态会促进肝脏分泌hepcidin,随后会导致铁循环减少,从而导致功能性铁缺乏。这两种急性期反应物在慢性肾病中都有各自的作用,它们在热带疾病和传染病中都被广泛用作标志物。慢性肾脏病患者c反应蛋白与hepcidin的相关性尚存争议。目的:分析非透析慢性肾病患者c反应蛋白与hepcidin的关系。我们对40名符合纳入和排除标准的非透析慢性肾脏疾病患者进行了一项观察性横断面研究。患者连续取样,并检查血清c反应蛋白和hepcidin水平。本研究共纳入40例受试者,男性占67.5%,平均年龄50.23±1.04岁。高血压是最常见的合并症(62.5%)。慢性肾脏疾病的常见分期为3期(40%)。血红蛋白平均值为10.74±0.36 g/dL,尿素氮平均值为39.98±29.59 mg/dL,肌酐平均值为4.12±3.39 mg/dL。平均血清c反应蛋白水平为3.52±5.13 mg/l。平均hepcidin水平为94、03±95、39 ng/ml。血清c反应蛋白水平与hepcidin值呈正相关(r=0.487),且显著相关(p值=0.001)。非透析慢性肾病患者c反应蛋白与hepcidin显著相关。
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