Hepcidin and its Related Hematological Biomarkers of Anemia in Children on Hemodialysis: Role of Carnitine Deficiency

Safinaz E. El-Toukhy; Fatina Fadel; Manal Elshamaa; Gamila S. M. El-Saeed; Hanan Abdelaziz; Marwa Elsonbaty; Eman A. Elghoroury; Eman Hamza; Soha Atef

doi:10.3889/oamjms.2020.4268

Authors

Safinaz E. El-Toukhy Department of Medical Biochemistry, National Research Centre, Cairo, Egypt
Fatina Fadel Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Manal Elshamaa Department of Pediatrics, National Research Centre, Cairo, Egypt
Gamila S. M. El-Saeed Department of Medical Biochemistry, National Research Centre, Cairo, Egypt
Hanan Abdelaziz Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Marwa Elsonbaty Department of Child Health, Medical Research Division, National Research Centre (Affiliation ID: 60014618), Cairo, Egypt; Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
Eman A. Elghoroury Department of Clinical and Chemical Pathology, National Research Centre, Cairo, Egypt
Eman Hamza Department of Clinical and Chemical Pathology, National Research Centre, Cairo, Egypt
Soha Atef Department of Clinical and Chemical Pathology, National Research Centre, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2020.4268

Keywords:

Hepcidin, High-sensitivity C-reactive protein, Carnitine, Anemia, Inflammation, Children, Hemodialysis

Abstract

BACKGROUND: Anemia is one of the most common complications in end-stage renal disease (ESRD) patients. Hepcidin is a hormone that regulates iron homeostasis in patients with ESRD. Carnitine deficiency is commonly seen in hemodialysis (HD) patients.

AIM: This study aimed to investigate the relationship between hepcidin and inflammatory and other anemia markers in children with ESRD and to evaluate the association of carnitine deficiency with anemia in these patients.

SUBJECTS AND METHODS: Thirty pediatric patients with ESRD undergoing HD, and thirty healthy, age- and sex-matched children served as controls were included in the study. Serum levels hepcidin, iron status, high-sensitivity C-reactive protein, and total carnitine were measured.

RESULTS: Statistically significant increases in serum levels of hepcidin (100.7 ± 0.99 ng\ml vs. 77.43 ± 0.8 ng\ml, p = 0.000), was found in HD children as compared to healthy controls. Statistically significant increase in serum levels of hs-CRP (3.94 ± 0.19 mg/l vs. 1.36 ± 0.07 mg/l, p = 0.04) was found in HD children as compared to healthy controls. However, serum levels of carnitine (29.59 ± 2.46 μmol/L vs. 36 ± 2.39 μmol/L, p = 0.000) showed statistically significant decreases in HD children as compared to healthy controls positive correlation was found between hepcidin and hs-CRP (r = 0.059, p = 0.042). Furthermore, a positive correlation was present between serum carnitine levels and serum iron levels (r = 0.651, p = 0.042).

CONCLUSION: Serum hepcidin may be a more useful biomarker of functional iron deficiency in children on HD. The efficacy of carnitine treatment for children on HD with carnitine deficiency and its effect on anemia needs to be studied.

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