The Relation Of Hepcidin With Other İnflammation Markers İn Dialyses Patients

The factors related to uremia, hypervolemi, hypertension and method of dialysies play an important role for improving complications by causing inflammation in dialysed patients. One of acute phase reactan called hepcidine mostly synthesised in liver and the synthesis of hepcidin increases in inflammation. Hepcidine causes anemia by way of functional ıron deficiency and it is an important mediator in chronic illness anemia. It is considered that the high levels of hepcidine in chronic renal failure related to decreased renal excretion of hepcidine and chronic inflammation state. In this study it is aimed to investigate the relation between the hepcidine, ıron levels and inflammation in hemodialyses and periton dialyses and the effects of hypervolemia on hepcidine levels. The study population was composed with for groups; normotensive, normovolemic patients with strict volume control and hemodialyses (n:20), normptensive with antihypertensive drugs and hypervolemic hemodialyses patients (n:19), periton dialyses patients (n:19), control group with healty volunters (n:20). Routine biochemical parametres, complete blood count, total iron, TIBC, ferritine, CRP, IL-1, IL-6, hepcidine and BNP levels were examined in all groups. The inflammation markers; hepcidine, CRP, IL-1 and IL-6, were higher in all dialyses groups than control group. Hepcidine, CRP, IL-1 and IL-6 levels were signaficantly high in hypervolemic hemodialyses group( p<0.05). Anemia was determined in all CRP groups (p<0.001). Anemia was more evident in hypervolemic hemodialyses group than normovolemic hemodialyses group and periton dialyses group. It is determined that serum iron and TSAT levels were lower in all dialyses patients than control group. ASlbumin level was higher in control group than all dialyses group (p<0.001). The level of albumin was lowest in hypervolemic hemodialyses patients (p<0.05). Inflammation is a common problem and a risc factor related to many complacations in CRF. Due to chronic inflammation the levels of acute phase reactans such as hepcidine, CRP and cytokines such as IL-1, IL-6 have increased in patients with CRF. Hypervolemia is one of an important reason of inflammation in dialyses patients. Higher levels of hepcidine and other inflammation marcers, lower levels of Hb, Hct, serum iron and TSAT in hypervolemic patients suggested that increased volume load improved the severity of inflammation related with complications. It is neccessary to reach real dry weight by strict volume control, effective and enough dialyses to supply the desired life quality in CRF patients. Key Words: Chronic renal failure, Dialyses, Inflammation, Hepcidine, Strict volume control