Abstract: ABSTRACT Objective: The current study was to investigate the change of hepcidin in the treatment of anemia and its interaction with iron supplement and Erythropoietin (EPO) agents in patients on maintenance hemodialysis (MHD), and to explore the therapy for iron homeostasis. Methods: 32 MHD patients for more than 6 months were enrolled in the study. Their hemoglobin level was lower than 110g/l. We gave them iron supplement and EPO treatment. Serum hepcidin was measured by ELISA. Iron metabolism index such as serum Fe, serum ferritin (SF) and transferrin saturation (TSAT) were measured by routine assays. The relationships between hepcidin with iron metabolism index, erythropoiesis, iron supplement or EPO agents were analyzed. Results: Serum hepcidin levels were significantly higher in patients on MHD than that in healthy control group（324±124.2VS72.4±12.3，p<0.001. It is also positively correlated with serum Fe (r=0.68,p=0.005), SF(r=0.62,p=0.004),TSAT(r=0.7,p=0.001), and negatively with reticulocyte count (r=-0.63,p=0.015). Regular hemodialysis can effectively remove hepcidin, and restore serum level to the original level in 2 weeks before hemodialysis. Treatment with EPO agents rather than iron supplement could decrease serum hepcidin levels.Conclusions: Serum hepcidin levels increasedin patients on MHD. Serum hepcidin may contribute to the abnormal iron metabolism and erythropoiesis. Timely and effectively removingf hepcidin from the body and treating with EPO can improve erythropoiesis and iron recycle, restore iron homeostasis, and prevent the further damage caused by iron overload.

Key words: Hepcidin, Maintenance hemodialysis, Iron homeostasis, Anemia, Treatment