Abstract: Objective To investigate the change of serum hepcidin in patients after switching from maintenance hemodialysis (MHD) to high- flux hemodialysis (HFD), and to analyse its related factors. Methods Forty MHD patients were enrolled. They were then changed to HFD for 12 months. Serum hepcidin, blood indices of iron metabolism, anemia and inflammation (high sensitivity C- reactive protein, hs- CRP) were assayed at 0 month, 2 months, 6 months and 12 months after the switching. Pearson correlation and multiple stepwise regression methods were used to analyze the relationship between serum hepcidin and these indices. Results Serum hepcidin levels after the switching for 2, 6 and 12 months were significantly higher than the level at 0 month (P＜0.01). Changes of ferritin and hs-CRP were consistent with the change of serum hepcidin. Pearson correlation analysis showed that serum hepcidin was positively correlated with serum iron (r= 0.164, P＜0.05), transferrin saturation (r=0.168, P＜0.05), ferritin (r=0.173, P＜0.05), hs-CRP (r=0.204, P＜ 0.01) and β2- microglobulin (r=0.692, P＜0.01). Multiple stepwise regression showed that transferrin saturation, hs-CRP, hemoglobin and β2-microglobulin levels were closely related to serum hepcidin level in HFD patients. Conclusions Serum hepcidin can reflect the iron storage in the body. Microinflammatory state is a key factor affecting hepcidin expression in hemodialysis patients. HFD may improve the iron metabolism status in MHD patients. Microinflammatory status is the important factor that influences the improvement processes.

Key words: Hepcidin, Hemodialysis, High-flux hemodialysis, Iron metabolism, Inflammation, Anemia