Effect of Serum Hepcidin on Predicting Mortality in Hemodialysis Patients: A Prospective Cohort Study

Background: Hepcidin is a key regulator of iron homeostasis, while the clinical utility of hepcidin remains uncertain in hemodialysis (HD) patients. Objectives: Our study aimed to evaluate the predictive effect of serum hepcidin-25 on mortality in HD patients. Methods: A prospective observational cohort study of chronic HD patients were conducted at Xuzhou Central Hospital, Jiangsu, China, during years 2015 2017. The data on demographic factors, dialysis vintage, comorbidities, and laboratory measures were collected. Kaplan-Meier survival analysis was used to compare the effect of serum hepcidin-25 levels on mortality. Logistic regression models and multivariate Cox proportional hazard models were performed to identify the predictors of all-cause mortality in HD patients. Results: A total of 159 patients were included in this cohort, who were stratified into three groups by tertiles of hepcidin-25 values, and their 2-year overall mortality rate was 11.94%. The Kaplan-Meier analysis showed that patients with the highest tertile of serum hepcidin-25 had significantly higher all-cause mortality than in the two lower tertiles (P < 0.001). Serum hepcidin-25 was an independent risk factor for all-cause mortality after multivariate adjustments using logistic regression models and Cox proportional hazard models. Conclusions: A higher level of serum hepcidin-25 in chronic HD patients could be associated with increased mortality. Further studies are needed in a larger size of HD patients with a longer term of follow up.