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Observational Study
. 2025 Nov;29(11):1627-1636.
doi: 10.1007/s10157-025-02692-x. Epub 2025 May 22.

The prognostic value of serum hepcidin-25 in predicting cardiovascular events among maintenance hemodialysis patients: insights from the INFINITY cohort

Tomomi Matsuoka  1 , Hyoe Tomita  2   3 , Tetsuo Tagami  3 , Noriaki Maruyama  4 , Makoto Yasuo  5 , Chinami Nagura  6   7 , Akiko Tsunemi  1 , Yoshihiro Nakamura  1 , Takashi Maruyama  1 , Masanori Abe  8 , Hiroki Kobayashi  9
Affiliations
Observational Study

The prognostic value of serum hepcidin-25 in predicting cardiovascular events among maintenance hemodialysis patients: insights from the INFINITY cohort

Tomomi Matsuoka et al. Clin Exp Nephrol. 2025 Nov.

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of mortality among maintenance hemodialysis patients, with iron metabolism disorders, particularly involving hepcidin, contributing to this heightened risk. This study aimed to evaluate whether serum hepcidin-25 levels are associated with the incidence of new CVD events in maintenance hemodialysis patients, using a novel, clinically applicable assay.

Methods: In this prospective, multicenter observational study, 567 maintenance hemodialysis patients from the INFINITY Cohort in Japan were followed for one year. Serum hepcidin-25 levels were measured using a latex turbidimetric immunoassay. The primary outcome was the incidence of new CVD events, including myocardial infarction, angina, and stroke. Logistic regression and Cox proportional hazards models were used to identify factors associated with new CVD events.

Results: During the one-year follow-up, 42 patients (7.4%) experienced new CVD events. Patients with new CVD events had significantly lower serum hepcidin-25 levels compared to those without events (19.0 vs. 37.8 ng/mL, P < 0.05). Multivariate logistic regression analysis revealed that lower hepcidin-25 levels (odds ratio 0.82, 95% confidence interval 0.72-0.94, P = 0.0036), higher glycoalbumin levels, and lower high-density lipoprotein cholesterol levels were independently associated with increased CVD risk.

Conclusions: Lower serum hepcidin-25 levels were independently associated with an increased risk of new CVD events in maintenance hemodialysis patients. Serum hepcidin-25 may serve as a potential biomarker for predicting cardiovascular risk, and addressing iron deficiency could help mitigate this risk.

Keywords: Cardiovascular disease; Hemodialysis; Hepcidin.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflicts of interest. Human or animals rights: Informed consent was obtained from all individual participants included in the study.

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