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Belo L, Rocha S, Valente MJ, Coimbra S, Catarino C, Bronze-da-Rocha E, Rocha-Pereira P, do Sameiro-Faria M, Oliveira JG, Madureira J, Fernandes JC, Miranda V, Santos-Silva A. Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients. Ren Fail 2020; 41:662-672. [PMID: 31296086 PMCID: PMC6691825 DOI: 10.1080/0886022x.2019.1635893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Soluble transferrin receptor (sTfR) is a biomarker of erythropoiesis, which is often impaired in dialysis patients. The aim of our study was to evaluate sTfR levels in chronically dialyzed patients and assess potential determinants of its levels. Methods: We performed a cross-sectional study by evaluating 246 end-stage renal disease patients undergoing dialysis and 32 healthy controls. Circulating levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, hepcidin, sTfR, growth differentiation factor 15 (GDF15), and traditional iron metabolism markers were measured, as well as hemogram parameters. Clinical data was obtained from all patients. Results: Compared to controls, patients presented similar values of sTfR, reticulocytes and reticulocyte production index (RPI), and significantly higher levels of IL-6, CRP, ferritin, hepcidin, TNF-α, and GDF15. Iron, transferrin, hemoglobin levels, erythrocyte count, mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) values were significantly lower in dialysis group. Within patients, sTfR values were higher in diabetic patients and were positively and significantly correlated with reticulocytes and erythrocytes, RPI, and therapeutic doses of erythropoiesis stimulating agents (ESA) and intravenous iron; and inversely and significantly correlated with circulating iron, ferritin, transferrin saturation, hepcidin, MCH, and MCHC. In multiple linear regression analysis, ESA dose, RPI, serum iron, diabetes, and hepcidin levels were independently associated with sTfR levels in dialysis patients and, thus, with erythropoiesis. Conclusion: Our data suggest that, besides RPI and ESA dose, diabetes and hepcidin are closely related to erythropoiesis in dialysis patients. The influence of diabetes on sTfR levels deserves further investigation.
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Affiliation(s)
- Luís Belo
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
| | - Susana Rocha
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
| | - Maria João Valente
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
| | - Susana Coimbra
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal.,b CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS) , Gandra-Paredes , Portugal
| | - Cristina Catarino
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
| | - Elsa Bronze-da-Rocha
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
| | - Petronila Rocha-Pereira
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal.,c Health Sciences Research Centre , University of Beira Interior , Covilhã , Portugal
| | - Maria do Sameiro-Faria
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal.,d Hemodialysis Clinic of Felgueiras, CHF , Felgueiras , Portugal
| | - José Gerardo Oliveira
- e Hemodialysis Clinic of Porto, CHP , Porto , Portugal.,f Center for Health Technology and Services Research (CINTESIS) , Faculty of Medicine, University of Porto , Porto , Portugal
| | - José Madureira
- g NefroServe Hemodialysis Clinic of Barcelos , Barcelos , Portugal
| | | | - Vasco Miranda
- i Hemodialysis Clinic of Gondomar, CHD , Gondomar , Portugal
| | - Alice Santos-Silva
- a UCIBIO, REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal
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