Journal of Hebei Medical University ›› 2022, Vol. 43 ›› Issue (5): 525-529.doi: 10.3969/j.issn.1007-3205.2022.05.006

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Role of the hepcidin/ferritin ratio in predicting heart failure in patients undergoing maintenance hemodialysis

  

  1. Department of Nephrology, People′s Hospital of Dongguan City, Guangdong Province, Dongguan 523000, China
  • Online:2022-05-25 Published:2022-05-30

Abstract:

Objective  To evaluate the application value of serum hepcidin and serum ferritin(SF) in predicting heart failure in patients undergoing maintenance hemodialysis, and to provide theoretical basis for clinical diagnosis and treatment.

Methods  A total of 110 heart failure patients undergoing maintenance hemodialysis were selected as heart failure group according to the Chinese guidelines for the diagnosis and treatment of heart failure. Meanwhile, 110 patients without heart failure undergoing maintenance hemodialysis admitted to this hospital were selected as non-heart failure group. Spearman method was used for correlation analysis, multivariate Logistic regression was used to analyze risk factors, and receiver operating characteristic curve(ROC) was used to evaluate the predictive value of hepcidin/SF ratio in cardiac function of patients undergoing maintenance hemodialysis.

Results  Compared with the non-heart failure group, the duration of dialysis, proportion of smoking and history of hyperlipidemia, hypersensitive C-reactive protein(hs-CRP), N-terminal pro-B-type natriuretic peptide(NT-proBNP), hepcidin, hepcidin/SF ratio, left ventricular end-diastolic diameter(LVEDD) and left atrial diameter(LAD) were higher, while hemoglobin, SF, and left ventricular ejection fraction(LVEF) were lower, with significant difference(P0.05). There were no significant differences in body mass index(BMI), serum calcium, serum phosphorus, albumin(ALB), fasting blood glucose(FBG) and interventricular septal thickness(IVS) between two groups(P0.05). In patients undergoing maintenance hemodialysis, serum hepcidin/SF ratio was positively correlated with NT-proBNP(r=0.706, P0.001). Multivariate Logistic regression analysis showed that duration of dialysis, smoking history, history of hyperlipidemia, hs-CRP and hepcidin/SF ratio were independent risk factors for heart failure in patients undergoing maintenance hemodialysis. In addition, ROC curve analysis showed that hepcidin/SF ratio could well distinguish patients undergoing maintenance hemodialysis who had heart failure(area under the curve was 0.929, 95%CI: 0.897-0.961, P0.001).

Conclusion  Hepcidin/SF ratio is significantly increased in heart failure patients undergoing maintenance hemodialysis, which can well predict the occurrence of heart failure in patients undergoing maintenance hemodialysis, and can be used as a biomarker for the early diagnosis and treatment of heart failure in patients undergoing maintenance hemodialysis.

Key words: renal dialysis, heart failure, hepcidin/serum ferritin ratio