Abstract: Objective To investigate plasma hepcidin level, the potential factors relating to hepcidin level, and its association with anemia and vascular calcification in maintenance hemodialysis (MHD) patients. Methods The MHD patients treated in Shanghai Ruijin Hospital from Jan. 1st, 2011 to Dec. 31st, 2011 were
enrolled in this study. Clinical characteristics and biochemical indices at baseline were collected. Blood samples at baseline were collected to determine plasma hepcidin level using ELISA method. The relationship between hepcidin level and anemia parameters and abdominal aortic calcification (AAC) was analyzed. Results A total of 216 MHD patients were enrolled in this study. The median plasma hepcidin level was 2,952.66 (1,131.38～6,076.72) pg/ml. Spearman analysis showed that significant negative correlations were observed between hepcidin level and red blood cell (r=-0.203, P=0.003), hemoglobin (r=-0.165, P=0.015), hematocrit (r=-0.182, P=0.007), total iron binding capacity (r=-0.467, P＜0.001) and transferrin (r=-0.362, P＜0.001); significant positive correlations were found between hepcidin level and mean corpuscular hemoglobin (r= 0.163, P=0.017), mean corpuscular hemoglobin concentration (r=0.156, P=0.022), transferrin saturation (rr= 0.193, P=0.004), ferritin (r=0.681, P＜ 0.001), C- reactive protein(CRP) (r=0.301, P＜0.001), and weekly ESA dose (r=0.146, P=0.032). Stepwise multivariate regression analysis showed that BMI (β=1.360, 95% CI 0.437～2.283, P=0.004), ferritin (β =0.061, 95% CI 0.046～0.077, P＜0.001), and CRP (β =3.532, 95% CI 0.887～6.177, P=0.009) were the independent risk factors for the increase of hepcidin level, and total iron binding capacity (β=-0.729, 95%CI -1.170～-0.288, P=0.001) was the independent inhibition factor for the increase of hepcidin level. Hepcidin level was positively correlated with AAC. Conclusion Plasma hepcidin level was related to anemia and iron metabolism parameters, inflammation factors and AAC, implying that hepcidin may participate in the pathogenesis of micro-inflammation state and vascular calcification.

Key words: Hemodialysis, Renal anemia, Hepcidin, Micro-inflammation state, Vascular calcification