Effect of different hemodialysis modalities on hepcidin clearance in patients undergoing maintenance hemodialysis

Introduction Hepcidin is a master regulator of iron utilization and takes part in the pathophysiology of anemia in maintenance hemodialysis (MHD) patients. Hepcidin is a moderate‐molecular‐weight substance and partially binds to plasma proteins in the circulation, which theoretically might be removed efficiently by hemoperfusion (HP). This study aimed to compare the effect of different dialysis modalities on hepcidin removal and discuss its effect on the iron and anemia status in MHD patients. Materials and Methods In a longitudinal interventional study of 26 stable MHD patients, the serum hepcidin, β2‐microglobulin (β2‐MG), and intact parathyroid hormone (iPTH) were measured before and after one treatment session of hemodialysis (HD), hemodiafiltration (HDF), HD + HP, and HDF + HP, separately. One‐way analysis of variance (ANOVA) was used to identify the effect of dialysis modalities on the intra‐dialysis clearance ratios. Results The combined dialysis modalities (HD + HP and HDF + HP) achieved greater clearance ratios of serum hepcidin than HD and HDF alone, HD + HP vs. HD (16 ± 15% vs. 4 ± 13%, p