Association the level of hepcidin, iron status, oxidative stress with inflammatory biomarkers in chronic renal disease hemodialysis patients

Chronic renal disease (CRD) remains a significant global health concern, characterized by impaired kidney function and various associated complications. Hemodialysis has become a critical treatment modality for managing advanced stages of CRD. One such area of interest is the relationship between hepcidin, iron status, oxidative stress, and inflammatory biomarkers in chronic renal disease hemodialysis patients. The study goal was to determine the relationship and levels of parameters and biomarkers such as lipid profile, electrolytes, CR-protein, IL-6, oxidative stress, and melatonin in hemodialysis patients. The study included a total of 120 volunteers, both male and female, within the age range of 35 to 70 years old. These participants were collected at the Kirkuk General Hospital in Kirkuk, Iraq, during the period from April to October 2021. The study participants were divided into two main groups: 80 patients, further subdivided into 40 individuals undergoing treatment for renal failure and 40 patients without any treatment, and a second group consisting of 40 healthy subjects to serve as a control. The results of the examination of gender distribution among 80 patients revealed that 46 (57.5%) were male, whereas 34 (42.5%) were female. According to iron, the findings showed a statistically significant (P<0.05) elevation in these levels, apparent in patients both without treatment (145.5 ± 11.51) and with treatment (107.8 ± 9.84), as compared to the levels observed within the control group (89.35 ± 7.2). While hepcidin showed statistical significance (P<0.05) of this elevation was notably noted in patients both without treatment (227.35 ± 14.38) and with treatment (131.62 ± 29.39), accentuating the contrast with hepcidin levels within the control group (115.02 ± 21.5). Furthermore, the levels of Interleukin-6 (IL-6) demonstrated a significant elevation (P < 0.05) in patients without treatment (6.85 ± 0.35) and those with treatment (4.78 ± 0.21), when compared to the control group (3.94 ± 0.25). Notably, CR protein levels exhibited a significant increase (P < 0.05) in patients without treatment (22.47 ± 3.75) and those receiving treatment (7.25 ± 1.28), compared to the control group (2.29 ± 0.42). The results displayed oxidative stress levels in patients with CKD. Those without treatment exhibited significantly elevated MDA levels (4.934 ± 1.04) compared to the control group (1.38 ± 0.29). In contrast, patients without treatment had significantly reduced GSH levels (0.241 ± 0.029) compared to the control group (0.482 ± 0.037), as well as patients with treatment (0.391 ± 0.053). Furthermore, showed that patients without treatment exhibited significantly elevated melatonin levels (42.95 ± 5.05) in comparison to the control group (25.08 ± 2.41). Those with treatment showed relatively lower melatonin levels (34.28 ± 3.51). In the studied groups, the lipid profile showed significant increases and decreases (P<0.05). Total cholesterol, triglyceride, LDL, and VLDL levels were significantly higher in hemodialysis and non-hemodialysis subjects compared to healthy subjects (P<0.05). HDL showed a significant decrease in patients with and without hemodialysis (P<0.05). Renal function parameters showed a significant increase in patients with and without hemodialysis compared to healthy subjects (P<0.05). In conclusion, these findings provide valuable insights into the risk factors and kidney functions associated with chronic renal failure among hemodialysis patients of Kirkuk in Iraq, emphasizing the need for appropriate management and treatment strategies.