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NDT Advance Access originally published online on January 3, 2008
Nephrology Dialysis Transplantation 2008 23(6):1886-1891; doi:10.1093/ndt/gfm900
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Alteration of mRNA expression of molecules related to iron metabolism in adenine-induced renal failure rats: a possible mechanism of iron deficiency in chronic kidney disease patients on treatment

Yasuhiro Hamada1, Tomoko-Nii Kono1, Yoshiyuki Moriguchi2, Masato Higuchi2 and Masafumi Fukagawa1

1 Division of Nephrology & Kidney Center, Kobe University School of Medicine, Kobe 2 Product Research Lab, Chugai Pharmaceutical Co., Ltd, Gotenba, Japan

Correspondence and offprint requests to: Correspondence and offprint requests to: Masafumi Fukagawa, Division of Nephrology & Dialysis Center, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Tel: +81-78-382-6500; Fax: +81-78-382-6509; E-mail: fukagawa{at}med.kobe-u.ac.jp



  Abstract

Background. Recombinant human erythropoietin (rHuEpo) is a definitive treatment for anaemia in chronic kidney disease (CKD). During long-term rHuEpo treatment most patients develop and show persistent iron deficiency in spite of oral iron supplementation. Abnormalities of iron absorption and transport in the duodenum may contribute to this deficiency.

Methods. To investigate changes in iron absorption and transport in CKD and iron deficiency against the background of rHuEpo treatment, we used severely anaemic rats with adenine-induced renal failure (adenine rats) and sham-treated control rats given only the vehicle. After 4 weeks on adenine or the vehicle, the rats were divided into four groups according to whether or not they received rHuEpo for the next 4 weeks: rHuEpo(–)-adenine, rHuEpo(–)-control, rHuEpo(+)-adenine and rHuEpo(+)-control. We evaluated the effects of rHuEpo treatment on iron balance, duodenal mRNA expression of molecules related to iron absorption and transport and hepatic mRNA expression of hepcidin.

Results. Treatment with rHuEpo improved anaemia and induced iron deficiency only in the adenine rats, in whom the expression of mRNAs for ferroportin 1 and hephaestin 1 increased and for divalent metal transporter 1 (DMT1) was unchanged. In contrast, control rats treated with rHuEpo showed no changes. Hepcidin mRNA expression was greater in adenine rats than in control rats.

Conclusions. In the adenine rats, rHuEpo treatment improved renal anaemia and induced persistent iron deficiency. An alteration of mRNA expression of molecules related to iron metabolism in renal insufficiency may be one of the reasons for this iron deficiency.

Keywords: adenine; anaemia; chronic kidney disease; erythropoietin; iron

Received for publication: 18. 1.07
Accepted in revised form: 27.11.07


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