Article

Hepcidin for clinicians.

Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Clinical Journal of the American Society of Nephrology (impact factor: 5.23). 07/2009; 4(8):1384-7. DOI:10.2215/CJN.02190309 pp.1384-7
Source: PubMed

ABSTRACT Despite the use of erythropoiesis-stimulating agents (ESAs), the anemia of chronic kidney disease (CKD) can be resistant to therapy. Both absolute and functional iron deficiency along with inflammation can contribute to ESA resistance and can be difficult to identify with current-day markers of iron storage. Hepcidin, a small peptide produced by the liver, is a recently discovered key regulator of iron homeostasis. Via regulation of ferroportin, hepcidin inhibits intestinal iron absorption and iron release from macrophages and hepatocytes. Because of its renal elimination and regulation by inflammation, it is possible that progressive renal insufficiency leads to altered hepcidin metabolism, subsequently affecting enteric absorption of iron and the availability of iron stores. Thus, hepcidin likely plays a major role in the anemia of CKD as well as ESA resistance. This article discusses the biologic actions and regulation of hepcidin along with reviewing studies of hepcidin in CKD.

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Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

article discusses
 
biologic actions
 
chronic kidney disease
 
CKD
 
current-day markers
 
discovered key regulator
 
enteric absorption
 
erythropoiesis-stimulating agents
 
ESA resistance
 
ESAs
 
hepcidin
 
hepcidin inhibits intestinal iron absorption
 
hepcidin likely
 
hepcidin metabolism
 
inflammation
 
iron homeostasis
 
iron storage
 
macrophages
 
progressive renal insufficiency
 
small peptide
 

Brian Young