الفهرس 
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Abstract
A reduction in the number of red blood cells in circulation indicates anemia. A reduction in hemoglobin (Hb) concentration, hematocrit, or red blood cell count is the clinical definition of anemia. In recent decades, chronic kidney disease (CKD) has become a significant global public health concern that requires further funding.
According to a recent estimate, 11% of the world’s population, or over 500 million individuals, have CKD. Anemia is linked to the onset of CKD, which affects patients’ clinical outcomes negatively. Early detection of CKD-related anemia thereby slows development, lowering rates of morbidity and death as well as the accompanying symptoms.
Anemia brought on by CKD has several complicated reasons. A reduction in the generation of endogenous erythropoietin (EPO), an absolute or functional iron deficiency, and inflammation with high hepcidin levels are a few of the symptoms. Erythropoiesis stimulating agents (ESA) and iron supplements are often administered to patients, either orally or intravenously.
It is widely known that CKD-related anemia is linked to poor clinical outcomes and a low quality of life. Treatment for CKD-related anemia must carefully balance erythropoiesis stimulation with iron and other component preservation in order to achieve appropriate hemoglobin (Hb) levels.
Hepcidin, a key regulatory protein that regulates intestinal iron absorption and iron distribution throughout the body, is the main regulator of iron metabolism. When hepcidin levels are high, the response to oral or intravenous (IV) iron is reduced. It is largely produced and released by the liver and pancreas cells and regulates both the body’s iron stores as well as intestinal iron absorption. Hepcidin is produced by pancreatic cells and is released when blood sugar levels are low. Hepcidin deficiency is considered to cause iron overload, which encourages cell death. Pro-inflammatory cytokines, acute phase reactants, and hepcidin levels are created in the early stages of CKD in addition to other components in order to achieve optimum hemoglobin (Hb) levels in CKD patients.
Understanding the immune response, iron homeostasis, and anemia in chronic illness may be possible thanks to hepcidin, an acute phase protein implicated in iron control. Hepcidin and ferritin have been linked in many studies. In terms of defining erythropoiesis, iron availability, and status, hepcidin performs better than ferritin. Hepcidin may thus be used to determine the presence of iron.
Hepcidin synthesis and release in CKD patients are influenced by a variety of variables, such as hypoxia, anemia, serum erythropoietin (EPO), transferrin saturation, and liver iron burden. Prohepcidin, hepcidin, and hepcidin metabolite concentrations are greater in CKD and dialysis patients, and the bulk of hepcidin is eliminated by the kidneys.
We want to identify the kind of anemia in children with chronic renal disease by measuring hepcidin levels.
In the Maternity and Children’s Hospital of Minia Governate’s dialysis unit, department, or pediatric nephrology clinic, we enrolled 60 patients with clinically and laboratory-confirmed chronic kidney disease and anemia aged 5 to 15 years, as well as 30 seemingly healthy kids of a similar age and sex who served as controls. The study was conducted from August 2021 to February 2022.
All children have been subjected to:
a complete history
therapeutic investigation
Among the tests carried out are the CBC, iron profile, renal function tests, and hepcidin level.
This study found connections between serum hepcidin, TIBC, iron, ferritin, and hemoglobin. High hepcidin levels and low hemoglobin levels often lead to anaemia. TIBC readings were normal despite low serum iron levels, indicating that CKD was the likely cause of the anemia. Serum hepcidin may be used to evaluate iron status, which is a risk factor for CKD, according to all of the studies.
Conclusion
Since it may discriminate between anemia brought on by chronic illnesses and iron deficiency anemia, hepcidin may be a valuable addition to the current battery of iron status diagnostic tests. Hepcidin and ferritin have been linked in many studies. In terms of defining erythropoiesis, iron availability, and status, hepcidin performs better than ferritin. Hepcidin might thus be used to check the presence of iron. On the other hand, further research would be required before the tests could be fully used in clinical practice and public health. This research would also be required to standardize the tests, assess the value of identifying certain hepcidin isoforms, establish clinical decision criteria, and make approved assays publicly available.
Recommendation:
1-.Hepcidin may be used as a marker to detect and classify the type of anemia, allowing us to treat anemic patients effectively, avoiding complications, and reducing mortality.
2- Expanding studies and research into anemia generally, and anemia in chronic renal illness specifically, in an effort to lower morbidity and death in these people.