P1501: hep-25/erfe ratio as a substantial prognostic marker of erythropoiesis in dialysis-dependent patients

Topic: 29. Iron metabolism, deficiency and overload Background: Anemia is one of the commonest clinical feature of chronic kidney disease (CKD). Hepcidin (HEP), a key factor of iron metabolism, regulation in CKD is complex influenced by renal function, iron status, and inflammation. Aims: This study aimed to evaluate the correlations between serum erythropoietin (EPO), erythroferrone (ERFE) and hepcidin (HEP-25) levels, and the utility of HEP-25/ERFE ratio as a predictor of erythropoiesis activity. Methods: This cohort study conducted on 35 patients with anemia related end stage CKD on sustained dose of short-acting erythropoiesis stimulating agent (ESA). Quantitative assessment of EPO, ERFE, and HEP in day zero, 5 and 7 consequently after ESA injection was performed using ELISA technique. Erythropoiesis activity was monitored by noting the increment in reticulocyte parameters between baseline day zero and day7. Results: Out of 35 dialysis-dependent patients, erythropoiesis outcomes were (54.3%) effective, (34.3%) ineffective and (11.4%) accelerated but ineffective. Though there was no significance difference in HEP/ERFE ratio and outcomes of erythropoiesis, the ratio was lower among those with effective than those with ineffective erythropoiesis. Summary/Conclusion: Reticulocyte parameter (RET-He) is a substantial predictor of abnormal iron utility and effectiveness of erythropoiesis in patients with CKD rather than HEP-25/ ERFE ratio. Keywords: Hepcidin, Anemia, Reticulocyte, Erythropoietin