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. 2016 Jun;48(6):839-44.
doi: 10.1007/s11255-016-1278-z. Epub 2016 Apr 4.

GDF-15, iron, and inflammation in early chronic kidney disease among elderly patients

Ewelina Lukaszyk  1 , Mateusz Lukaszyk  2 , Ewa Koc-Zorawska  1 , Anna Bodzenta-Lukaszyk  2 , Jolanta Malyszko  3
Affiliations

GDF-15, iron, and inflammation in early chronic kidney disease among elderly patients

Ewelina Lukaszyk et al. Int Urol Nephrol. 2016 Jun.

Abstract

Purpose: The aim of the study was to assess GDF-15 and iron status in patients in early stages of chronic kidney disease with a particular emphasis on elderly population in association of classic iron status parameters with novel iron homeostasis biomarkers and inflammatory parameters.

Methods: Serum concentrations of GDF-15, iron (Fe), transferrin saturation, soluble transferrin receptor (sTfR), hepcidin, high-sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6), and hemoglobin were measured in 56 patients ≥65 years of age and in 31 <65 years of age.

Results: In patients ≥65 years, serum concentrations of GDF-15 and hsCRP were significantly higher in comparison with younger group. There was no statistically significant difference in hemoglobin, iron, hepcidin, and sTfR concentration between the two studied groups. In both groups GDF-15 was significantly correlated with hemoglobin, eGFR, hsCRP, and IL-6. GDF-15 was significantly higher in patients with anemia in comparison with their non-anemic counterparts. In multivariate analysis, hemoglobin was found to be a predictor of log GDF-15 (beta value = 0.36, P = 0.006, R (2) = 37 %).

Conclusions: An intricate interplay between renal function, anemia, and GDF-15 concentrations awaits further studies, as there are few data regarding pathophysiological role of GDF-15 in diabetes, kidney disease, and other comorbidities. Further understanding regarding the signaling pathways of GDF-15 may help to discover next pieces in the exciting puzzle of GDF-15. Finally, as studies dealing with normal level of GDF-15 in the healthy aged are lacking, it is possible that the higher values of GDF-15 values found in the present study represent values of GDF-15 according to age more than CKD levels.

Keywords: Chronic kidney disease; GDF-15; Hepcidin; Inflammation; Iron.

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Figures

Fig. 1
Fig. 1
Correlation between GDF-15 and hemoglobin in patients ≥65 years (r = −0.52, P < 0.005)
Fig. 2
Fig. 2
GDF-15 in patients with and without anemia
Fig. 3
Fig. 3
GDF-15 in patients without and with diabetes mellitus
See this image and copyright information in PMC

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