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Biomarkers of iron metabolism in chronic kidney disease

Iron is the most abundant transition metal in the human body and an essential element required for growth and survival. Our understanding of the molecular control of iron metabolism has increased dramatically over the past 20 years due to the discovery of hepcidin, which regulates the uptake of diet...

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Autores principales: Tomasz, Glogowski, Ewa, Wojtaszek, Jolanta, Malyszko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087561/
https://www.ncbi.nlm.nih.gov/pubmed/33025407
http://dx.doi.org/10.1007/s11255-020-02663-z
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author Tomasz, Glogowski
Ewa, Wojtaszek
Jolanta, Malyszko
author_facet Tomasz, Glogowski
Ewa, Wojtaszek
Jolanta, Malyszko
author_sort Tomasz, Glogowski
collection PubMed
description Iron is the most abundant transition metal in the human body and an essential element required for growth and survival. Our understanding of the molecular control of iron metabolism has increased dramatically over the past 20 years due to the discovery of hepcidin, which regulates the uptake of dietary iron and its mobilization from macrophages and hepatic stores. Anemia and iron deficiency are common in chronic kidney disease. The pathogenesis of anemia of chronic kidney disease is multifactorial. Correction of anemia requires two main treatment strategies: increased stimulation of erythropoiesis, and maintenance of an adequate iron supply to the bone marrow. However, there are still many uncertainties in regard to iron metabolism in patients with chronic kidney disease and in renal replacement therapy. The aim of this review was to summarize the current knowledge on iron metabolism in this population, including new biomarkers of iron status. There is an area of uncertainty regarding diagnostic utility of both erythroferrone (ERFE) and hepcidin in end-stage renal disease (ESRD) patients. Higher concentration of hepcidin in oligoanuric patients may reflect decreased renal clearance. Furthermore, the hepcidin-lowering effect of ERFE in ESRD patients treated with erythropoiesis-stimulating agents (ESAs) may be blunted by underlying inflammation and concomitant iron treatment. Thus, future studies should validate the use of ERFE as a biomarker of erythropoiesis and predictor of response to iron and ESA therapy in dialysis-dependent patients.
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spelling pubmed-80875612021-05-05 Biomarkers of iron metabolism in chronic kidney disease Tomasz, Glogowski Ewa, Wojtaszek Jolanta, Malyszko Int Urol Nephrol Nephrology - Review Iron is the most abundant transition metal in the human body and an essential element required for growth and survival. Our understanding of the molecular control of iron metabolism has increased dramatically over the past 20 years due to the discovery of hepcidin, which regulates the uptake of dietary iron and its mobilization from macrophages and hepatic stores. Anemia and iron deficiency are common in chronic kidney disease. The pathogenesis of anemia of chronic kidney disease is multifactorial. Correction of anemia requires two main treatment strategies: increased stimulation of erythropoiesis, and maintenance of an adequate iron supply to the bone marrow. However, there are still many uncertainties in regard to iron metabolism in patients with chronic kidney disease and in renal replacement therapy. The aim of this review was to summarize the current knowledge on iron metabolism in this population, including new biomarkers of iron status. There is an area of uncertainty regarding diagnostic utility of both erythroferrone (ERFE) and hepcidin in end-stage renal disease (ESRD) patients. Higher concentration of hepcidin in oligoanuric patients may reflect decreased renal clearance. Furthermore, the hepcidin-lowering effect of ERFE in ESRD patients treated with erythropoiesis-stimulating agents (ESAs) may be blunted by underlying inflammation and concomitant iron treatment. Thus, future studies should validate the use of ERFE as a biomarker of erythropoiesis and predictor of response to iron and ESA therapy in dialysis-dependent patients. Springer Netherlands 2020-10-06 2021 /pmc/articles/PMC8087561/ /pubmed/33025407 http://dx.doi.org/10.1007/s11255-020-02663-z Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Nephrology - Review
Tomasz, Glogowski
Ewa, Wojtaszek
Jolanta, Malyszko
Biomarkers of iron metabolism in chronic kidney disease
title Biomarkers of iron metabolism in chronic kidney disease
title_full Biomarkers of iron metabolism in chronic kidney disease
title_fullStr Biomarkers of iron metabolism in chronic kidney disease
title_full_unstemmed Biomarkers of iron metabolism in chronic kidney disease
title_short Biomarkers of iron metabolism in chronic kidney disease
title_sort biomarkers of iron metabolism in chronic kidney disease
topic Nephrology - Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087561/
https://www.ncbi.nlm.nih.gov/pubmed/33025407
http://dx.doi.org/10.1007/s11255-020-02663-z
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