Relationship between serum iron, total iron binding capacity, transferrin saturation and hepcidin in patients with stage 3-5 non-dialysis chronic kidney disease

Background: Functional iron deficiency anemia is one of the complications that often occurs in patients with chronic kidney disease. Imbalance of hepcidin can induce iron disorder which is the pathophysiology of anemia in chronic kidney disease. Measurement of serum iron, total iron binding capacity and transferrin saturation aims to determine the availability of iron in the circulation. This study determines the relationship between serum iron, total iron binding capacity, transferrin saturation and hepcidin in non-dialysis chronic kidney disease. Objective: Determining the relationship between serum iron, total iron binding capacity, transferrin saturation and hepcidin in stage 3-5 non-dialysis chronic kidney disease. Methods: This cross-sectional analytic observational study evaluates 37 stage 3-5 non-dialysis chronic kidney disease patients whose age between 20 to 80 years old in outpatient nephrology clinic of Dr. Soetomo Hospital. Serum iron, total iron binding capacity, transferrin and hepcidin saturation levels are measured. This study is done by consecutive sampling and spearman parametric test is used to analyze the data. Results: Of the 37 subjects, 67.6% are men with mean age is 56.84 ± 12.27 years. Most patients in this study is in stage 3. The mean hemoglobin, serum creatinine, serum iron and total iron binding capacity levels in the subjects of this study are 10.88 ± 2.21 g/dl, 3.42 ± 2.25 mg/dl, 64.86 ± 24.15 mg/dl and 235.1 ± 67.45 ng/dl consecutively. Median transferin saturation and hepcidin levels are 27% (4 – 88%) and 48.58 mg/dl (0.12-439.07 ng/ml). There is a relationship between total iron binding capacity and hepcidin with negative correlation coefficient of-0.72 (p = 0.000), but there is no relationship between serum iron and transferrin saturation with hepcidin. Conclusion: In this study, there is a significant negative relationship with moderate strength between total iron binding capacity and hepcidin. The r value is-0.725 with p = 0.000.