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  • 1
    Online Resource
    Online Resource
    Wiley ; 2016
    In:  European Journal of Clinical Investigation Vol. 46, No. 12 ( 2016-12), p. 994-1001
    In: European Journal of Clinical Investigation, Wiley, Vol. 46, No. 12 ( 2016-12), p. 994-1001
    Abstract: Hepcidin is considered the master regulator of iron homoeostasis. Novel hepcidin antagonists have recently been introduced as potential treatment for iron‐restricted anaemia. Meanwhile, serum hepcidin has been shown to be positively associated with cardiovascular disease and inversely with acute kidney injury. These properties may lead to contrasting effects, especially in renal transplant recipients (RTR), which are prone to cardiovascular diseases and graft failure. To date, the role of serum hepcidin in RTR is unknown. We, therefore, prospectively determined the association of serum hepcidin with risk of graft failure, cardiovascular mortality and all‐cause mortality in RTR. Materials and methods Serum hepcidin was assessed in an extensively phenotyped RTR cohort by dual‐monoclonal sandwich ELISA specific immunoassay. Statistical analyses were performed using univariate linear regression followed by stepwise backward linear regression. Cox proportional hazard regression models were performed to determine prospective associations. Results We included 561 RTR (age 51 ± 12 years). Mean haemoglobin (Hb) was 8·6 ± 1·0 mM. Median [IQR] serum hepcidin was 7·2 [3·2–13·4] ng/mL. Mean estimated glomerular filtration rate was 47 ± 16 mL/min/1·73 m 2 . In univariate Cox regression analyses, serum hepcidin was not associated with risk of graft failure, cardiovascular mortality or all‐cause mortality. Notably, after adjustment for high sensitivity C‐reactive protein and ferritin, serum hepcidin became negatively associated with all‐cause mortality (hazard ratio 0·89; 95% confidence interval 0·80–0·99, P = 0·03). Conclusions In this study, we did not find an association between serum hepcidin and outcomes, that is graft failure, cardiovascular mortality or all‐cause mortality. Based on our results, it is questionable whether serum hepcidin may be used to predict a beneficial effect of hepcidin antagonists.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2004971-7
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  • 2
    In: American Journal of Hematology, Wiley, Vol. 92, No. 8 ( 2017-08)
    Type of Medium: Online Resource
    ISSN: 0361-8609 , 1096-8652
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 1492749-4
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  • 3
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 13, No. 4 ( 2022-08), p. 2044-2053
    Abstract: Post‐transplant anaemia and reduced muscle mass and strength are highly prevalent in kidney transplant recipients (KTRs). Decreased haemoglobin levels, a marker of anaemia, could adversely affect muscle mass and strength through multiple mechanisms, among others, through diminished tissue oxygenation. We aimed to investigate the association between haemoglobin levels with muscle mass and strength in KTRs. Methods We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft ≥1 year post‐transplantation. Muscle mass was assessed using 24 h urinary creatinine excretion rate (CER) and bioelectrical impedance analysis (BIA). Muscle strength was assessed with a handgrip strength test using a dynamometer and, in a subgroup ( n  = 290), with the five‐times sit‐to‐stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength. Results In 871 included KTRs [median age 58 (interquartile range (IQR), 48–66)] years; 60% men; eGFR 51 ± 18 mL/min/1.73 m 2 ) who were 3.5 (1.0–10.2) years post‐transplantation, the mean serum haemoglobin level was 13.9 ± 1.8 g/dL in men and 12.8 ± 1.5 g/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. β = 0.07, P  = 0.01), BIA‐derived skeletal muscle mass (std. β = 0.22, P   〈  0.001), handgrip strength (std. β = 0.15, P   〈  0.001), and worse FTSTS test scores (std. β = −0.17, P  = 0.02). KTRs in the lowest age‐specific and sex‐specific quartile of haemoglobin levels had an increased risk of being in the worst age‐specific and sex‐specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15–3.77; P  = 0.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95–5.59; P   〈  0.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59–20.05; P   〈  0.001). Conclusions Low haemoglobin levels are strongly associated with decreased muscle mass and strength in KTRs. Future investigation will need to investigate whether maintaining higher haemoglobin levels may improve muscle mass and strength in KTRs.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2586864-0
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