The Relationship of Serum Hemojuvelin and Hepcidin Levels with Iron level and Erythropoietin requirement in Prevalent Hepatitis C virus positive Hemodialysis Patients

Background Iron overload is frequently reported in hemodialysis (HD) patients particularly those with chronic hepatitis C virus (HCV) infection. Soluble Hemojuvelin (sHJV) has recently emerged as one of the significant regulators of iron homeostasis and hepcidin expression. Aims to evaluate the potential associations of sHJV and hepcidin with inflammation, iron parameters and Erythropoietin requirement in prevalent HD patients with HCV. Methods Serum sHJV and hepcidin were measured in 60 prevalent HD patients with [group I (n = 30)] and without [group II (n = 30)] HCV, and controls (n = 30) by enzyme-linked immunosorbent assay. Parameters related to anemia, iron metabolism, inflammation, sHJV and hepcidin were measured. Results Serum hepcidin in HCV positive versus negative groups was 89.40 ± 46.08 ng/mL and 224.1 ± 72.36 ng/mL, p = 0.000, respectively while sHJV was 245 ± 1.338 ng/mL and 254 ± 0.762 ng/mL, p = 0.147, respectively in positive versus negative patients. In group I, hepcidin correlated with serum ferritin (r = -0.512 p = 0.005) and transferrin saturation (TSAT%) (r = 0.572, p = 0.000) and sHJV correlated with ferritin (r = 0.40, P 0.000), TSAT% (r = 0.450, p = 0.002) and a significant correlation also existed between sHJV and hepcidin (r = -0.259, P 0.045). In the regression analysis, ferritin and TSAT% were able to predict sHJV; (standardized β = 0.52, P 0.001) and (standardized β = 0.48, P 0.010). Ferritin and sHJV were also able to predict hepcidin (standardized β = 0.627, P = 0.006) and (standardized β = 0.300, P = 0.007) in group I. Conclusion sHJV levels seem to be associated with iron overload parameters and hepcidin levels in HCV positive HD patients.