Anemia is a common clinical problem in
end-stage renal disease (
ESRD). Despite adequate
erythropoiesis-stimulating agent (ESA) supplementation, some
ESRD patients still have suboptimal
hemoglobin levels, and
iron deficiency and
inflammation are recognized as the two most common causes.
Hepcidin, a newly discovered key regulator of
iron homeostasis, is found to be accumulated in
ESRD. As it controls
iron uptake and release, better reflecting real-time
iron demand and availability,
hepcidin might become a target in the management of
iron deficiency and ESA resistance in dialysis patients. For their pleiotropic functions apart from
lipid-modulation,
statins are also used as anti-inflammatory or immune-modulating agents. In this study, we applied
simvastatin for the purpose of influencing serum
prohepcidin level in a group of maintenance
hemodialysis patients. Thirty-three
ESRD patients undergoing
hemodialysis were enrolled and assigned to experimental and
hemodialysis control groups according to their
lipid profile. Nineteen healthy adults were chosen as a normal control group. The subjects in the experimental group took 20 mg
simvastatin orally per night for eight weeks, and those in the
hemodialysis control group took no
statins or any other
lipid-modulating drugs. Before and after the experiment, the serum
prohepcidin concentrations, plasma
IL-6, and serum
C-reactive protein (CRP),
ferritin,
hemoglobin,
albumin, total
cholesterol, glycerinate, and
LDL and
HDL cholesterol levels were determined. Of the 33
hemodialysis patients, the serum
prohepcidin concentration was (175.8 +/- 52.9) ng/mL, significantly higher than that in the normal control group (149.5 +/- 24.2) ng/mL (P = 0.048). In the experimental group, the serum
prohepcidin level was (156.7 +/- 51.9) ng/mL before treatment, and (190.6 +/- 49.6) ng/mL after eight weeks (P = 0.127). In the
hemodialysis control group, the serum
prohepcidin level was (190.6 +/- 49.6) ng/mL at the beginning, and (193.5 +/- 36.0) ng/mL after eight weeks (P = 0.728). In the experimental group, after taking
simvastatin for eight weeks the serum total
cholesterol and
triglyceride levels had lowered by 18.6% (P = 0.004) and 55.1% (P = 0.007), respectively. The plasma
IL-6, serum CRP,
ferritin,
hemoglobin,
albumin, and
LDL and
HDL cholesterol levels in both the
hemodialysis group remained unchanged. According to our preliminary study, eight weeks of 20 mg
simvastatin did not significantly change the serum
prohepcidin, high-sensitive CRP, or
IL-6 concentrations in the group of maintenance
hemodialysis patients.