Serum Erythroferrone, a Biomarker of Erythropoietic Activity in End-Stage Renal Disease Patients

Document Type : Original Article

Authors

1 Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Clinical Pathology Department, Faculty of Medicine, Ain Shams University. Cairo, Egypt

3 Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

4 Clinical Pathology, MOH, Egypt

Abstract

Background: Hepcidin, a negative iron regulator, causes erythropoietin deficiency and reduced iron availability being the main cause of anaemia in chronic kidney disease (CKD). On the other hand, the erythropoietic stimulating agent inhibits hepcidin and increases the absorption and, mobilization of iron, stimulation of erythropoiesis, and curing anaemia through the production of erythroferrone. The research aimed to study the role of ERFE as a potential clinical biomarker for assessing erythropoiesis in end-stage renal disease (ERD) patients with iron deficiency anaemia.
Methods: Forty ERD patients (GFR < 15 ml/min/1.73 m2) with signs of iron deficiency anaemia were included in a case-control study. ERFE was assessed by ELISA both before and after iron/ESA treatment.
Result: The patient groups' ERFE levels were significantly different from the control group's either at baseline or following therapy (p=0.016 & 0.023, respectively). Patients receiving both iron and EPO had the greatest amount (212.31±106.33 ng/L at baseline and 520.00±255.26 post-treatment). It was shown that there was a positive correlation (p-value <0.05) between the ERFE level and serum iron and hemoglobin.
Conclusion: To manage anaemia in ESRD patients, it is worth creating new diagnostic and therapeutic techniques by understanding iron homeostasis. The link between ERFE and iron/EPO therapy as well as its positive correlation with hemoglobin and blood iron levels was established. Thus, ERFE may have a significant impact on the management of patients with iron deficiency as well as the evaluation of erythropoietic function.

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