Relationship Between Prohepcidin and Cardiovascular Risk Markers in End Stage Renal Failure Patients

OBJECTIVE: The leading cause of death in patients with end-stage renal disease (ESRD) is cardiovascular disease. Prohepcidin, which is the precursor of hepcidin is a peptide hormone produced by the liver, and appears to be the master regulator of iron homeostasis in humans. High prohepcidin levels may contribute to progression of cardiovascular disease in end-stage renal insufficiency patients. However, any such association remains poorly understood. The purpose of the present study was to investigate the relationship between prohepcidin and cardiovascular risk markers in end-stage renal failure patients. MATERIAL and METHODS: Twenty-two chronic hemodialysis patients, 21 chronic peritoneal dialysis patients, and 16 healthy controls were included in the present study. The levels of serum prohepcidin (the precursor form of hepcidin), high sensitivity C-reactive protein (hs-CRP), troponin-T (TT), and cystatin C (CC) were determined using commercial kits. The left ventricular mass index (LVMI) was estimated using echocardiography. RESULTS: The levels of the CVD risk markers TT, CC, and prohepcidin differed, with statistical significance, between the patient and control groups. Prohepcidin level was significantly associated with CC concentration (beta=0.855, R2=0.73, p<0.001), TT level (beta=0.456, R2=0.20, p=0.002), and the LVMI (beta=0.435, R2=0.19, p=0.003). However, no significant association between prohepcidin level and hs-CRP concentration was evident (beta=0.124, R2=0.015, p<0.42). CONCLUSION: Our data suggest that the prohepcidin level can serve as a biomarker of cardiovascular disease. This level is closely associated with the cardiovascular risk markers of CC and TT concentrations, as well as the LVMI.