Association between baseline serum hepcidin levels and infection in kidney transplant recipients: Potential role for iron overload

作者：Fernandez Ruiz Mario^*; Parra Patricia; Ruiz Merlo Tamara; Lopez Medrano Francisco; San Juan Rafael; Polanco Natalia; Gonzalez Esther; Andres Amado; Maria Aguado Jose

来源：Transplant Infectious Disease, 2018, 20(1): e12807.

DOI：10.1111/tid.12807

• hepcidin-25
• infection
• iron metabolism
• iron overload
• kidney transplantation

BackgroundThe liver-synthesized peptide hepcidin is a key regulator of iron metabolism and correlates with total iron stores. We analyzed the association between pre-transplant hepcidin-25 levels and infection after kidney transplantation (KT).
MethodsSerum hepcidin-25 levels were measured at baseline by high-sensitivity ELISA in 91 patients undergoing KT at our institution between December 2011 and March 2013. The impact of this biomarker on the incidence of post-transplant infection (excluding lower urinary tract infection) during the first year was assessed by Cox regression.
ResultsMean hepcidin-25 level was 82.367.4ng/mL and strongly correlated with serum ferritin (Spearman's rho=0.703; P<.001). There were no significant differences in hepcidin-25 levels between patients with or without overall infection (96.4 +/- 67.5 vs 72.6 +/- 66.7ng/mL; P=.101). Such difference was evident for opportunistic (128.9 +/- 75.0 vs 73.0 +/- 62.3ng/mL; P=.003) and, to a lesser extent, surgical-site infection (107.5 +/- 73.3 vs 76.5 +/- 65.2ng/mL; P=.087). Patients with hepcidin-25 levels 72.5ng/mL had higher 12-month cumulative incidence of overall infection (51.2% vs 29.2%; P=.032). After multivariate adjustment, hepcidin-25 72.5ng/mL acted as an independent risk factor for overall (adjusted hazard ratio [aHR] 3.86; 95% confidence interval [CI] 1.49-9.96; P=.005) and opportunistic infection (aHR 4.32; 95% CI 1.18-15.75; P=.027).
ConclusionElevated baseline serum hepcidin-25 levels were associated with increased risk of infection after KT, suggesting a role for iron overload in the individual susceptibility to post-transplant infection.

• 出版日期2018-2