الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Hepcidin is a peptide hormone produced in the liver that plays a crucial role in iron homeostasis. Hepcidin is an acute-phase reactant, one of many molecules whose plasma concentration changes in response to inflammation. During states of acute or chronic inflammation, levels of hepcidin and other acute-phase reactants increase, leading to a decrease in serum iron levels as hepcidin levels rise. Hepcidin production increases in response to iron overload, inflammation or infection, while its synthesis is diminished because of iron deficiency, increased erythropoiesis and hypoxia This cross-sectional study was conducted on 64 adult subjects (>18 years) forty eight patients with anemia who had CKD stage 4 with glomerular filtration rate (GFR) 15-29 ml/min/1.73 m2. The studied cases were divided into 4 groups: group (1): includes 16 patients with Hb level below 6 gm/dl. group (2): includes 16 patients with Hb level between 6 -9 gm/dl. group (3): includes 16 patients with Hb level above 9 gm/dl In addition, group (4): includes 16 healthy individuals as control group.In group 1, there was significant negative correlation between hepcidin level with GFR, Hb. (p= 0.031 and 0.027, respectively) and significant positive correlation with ferritin and CRP (p= 0.024 and 0.019, respectively). However, there was no significant correlation between hepcidin level with age, weight, creatinine, HCT, iron, TSAT, transferrin and TIBC (p-value was >0.05).In group 2, there was significant negative correlation between hepcidin level with GFR (p= 0.011) and significant positive correlation with Tsat and CRP (p= 0.004 and 0.002, respectively). However, there was no significant correlation between hepcidin level with age, weight, creatinine, HGB, HCT, iron, transferrin, ferritin and TIBC (p-value was >0.05).In group 3, there was significant negative correlation between hepcidin level with GFR (p= 0.003) and significant positive correlation with Tsat, ferritin, and CRP (p= 0.004, 0.020 and 0.018, respectively). However, there was no significant correlation between hepcidin level with age, weight, creatinine, HGB, HCT, iron, transferrin and TIBC (p-value was >0.05)
In group 4, there was no significant correlation between hepcidin level with s. age, weight, creatinine, GFR, Hb., HCT, iron, TSAT, transferrin, TIBC, ferritin and CRP (p-value was >0.05).Using ROC curve, it was shown that: hepcidin can be used to discriminate between anemic groups and control group at a cutoff level of > 6.6 ng/ml, with 93.7% sensitivity, 100% specificity, 100% PPV and 94.07% NPV (AUC = 0.996 & p-value < 0.001).