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Biomarkers of iron metabolism in chronic kidney disease
- Source :
- International Urology and Nephrology
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Iron is the most abundant transition metal in the human body and an essential element required for growth and survival. Our understanding of the molecular control of iron metabolism has increased dramatically over the past 20 years due to the discovery of hepcidin, which regulates the uptake of dietary iron and its mobilization from macrophages and hepatic stores. Anemia and iron deficiency are common in chronic kidney disease. The pathogenesis of anemia of chronic kidney disease is multifactorial. Correction of anemia requires two main treatment strategies: increased stimulation of erythropoiesis, and maintenance of an adequate iron supply to the bone marrow. However, there are still many uncertainties in regard to iron metabolism in patients with chronic kidney disease and in renal replacement therapy. The aim of this review was to summarize the current knowledge on iron metabolism in this population, including new biomarkers of iron status. There is an area of uncertainty regarding diagnostic utility of both erythroferrone (ERFE) and hepcidin in end-stage renal disease (ESRD) patients. Higher concentration of hepcidin in oligoanuric patients may reflect decreased renal clearance. Furthermore, the hepcidin-lowering effect of ERFE in ESRD patients treated with erythropoiesis-stimulating agents (ESAs) may be blunted by underlying inflammation and concomitant iron treatment. Thus, future studies should validate the use of ERFE as a biomarker of erythropoiesis and predictor of response to iron and ESA therapy in dialysis-dependent patients.
- Subjects :
- Nephrology
medicine.medical_specialty
Anemia
Iron
Urology
medicine.medical_treatment
Hepcidin
030232 urology & nephrology
030204 cardiovascular system & hematology
Gastroenterology
Nephrology - Review
03 medical and health sciences
0302 clinical medicine
Hepcidins
Chronic kidney disease
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Renal replacement therapy
Renal Insufficiency, Chronic
biology
business.industry
Iron deficiency
Erythroferrone
Iron metabolism
medicine.disease
biology.protein
Erythropoiesis
business
Biomarkers
Kidney disease
Subjects
Details
- ISSN :
- 15732584 and 03011623
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- International Urology and Nephrology
- Accession number :
- edsair.doi.dedup.....8ff983b74d4b8893c4f5921e40e95fcd