{"id":"8684e9a4ec78","type":"article","url":"https://hartvaat.nl/2026/10/20/hoge-en-lage-hepcidineniveaus-voorspellen-ongunstige-nier-en-cardiovasculaire-ui/","title":"Hoge en lage hepcidineniveaus voorspellen ongunstige nier en cardiovasculaire uitkomsten bij chronisch nierpatiënten","title_en":"The Chronic Renal Insufficiency Cohort (CRIC) study measured hepcidin, cardiovascular, kidney and metabolic outcomes in chronic kidney disease.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Kidney international","doi":"10.1016/j.kint.2026.10.006","source_url":"https://doi.org/10.1016/j.kint.2026.10.006","authors":["Monique E Cho","Rupal C Mehta","Tom Greene","Jared L Hansen","Carol Sweeney","Alfred K Cheung","Myles Wolf","Hernan Rincon-Choles","Jesse Hsu","Dominic Raj","Sylvia E Rosas","James Lash","Chi-Yuan Hsu","Mirela Dobre","Mark L Unruh","Panduranga Rao","Nora Fino"],"significance":5,"published":"2026-10-29","source_date":"2026-10-20","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/"],"congress":"","summary_en":"The CRIC cohort study evaluated whether plasma hepcidin levels predict cardiovascular and renal outcomes in 3,826 patients with chronic kidney disease. Patients in the highest hepcidin tertile had a significantly increased risk of kidney progression (HR 1.19) and atherosclerotic events (HR 1.34), whereas the lowest tertile was linked to higher all-cause and cardiovascular mortality. These findings suggest that both elevated and suppressed hepcidin serve as markers of adverse outcomes, highlighting its potential role in refining risk stratification for cardiorenal patients.","created":"2026-10-22T01:12:03Z","updated":"2026-10-22T01:12:03Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In de CRIC-cohortstudie onderzochten onderzoekers of plasmahepcidineniveaus de kans op cardiovasculaire en nieruitkomsten voorspellen bij 3826 patiënten met chronisch nierfalen. Patiënten in het hoogste hepcidine-tertiel hadden een verhoogd risico op nierverslechtering (HR 1,19) en atherosclerotische gebeurtenissen (HR 1,34), terwijl het laagste tertiel geassocieerd werd met een hoger risico op alle-oorzaak en cardiovasculaire mortaliteit. Deze bevindingen benadrukken dat zowel een te hoog als een te laag hepcidine een signaal is voor verhoogd risico, wat relevant kan zijn voor risicostratificatie in de nefrologische en cardiologische praktijk.","abstract_original":"INTRODUCTION: Abnormal iron homeostasis plays a critical role in extra-hematopoietic disorders. The relationship of hepcidin, the master iron regulator, to clinical outcomes, has not been characterized in a large cohort of chronic kidney disease (CKD). METHODS: To determine if plasma hepcidin level predicts cardiovascular (CV), kidney, and metabolic outcomes in patients with CKD, we studied 3826 patients enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Hazard ratios for hepcidin tertiles were estimated from Cox Proportional Hazards regression for primary outcomes of incident heart failure (HF), end stage kidney disease (kidney failure) or halving of the estimated glomerular filtration rate (eGFR), and new onset diabetes or prediabetes. Secondary outcomes included atherosclerotic events and all-cause and CV mortality. RESULTS: The median and interquartile range of plasma hepcidin level was 43 (22, 77) ng/mL. Higher plasma hepcidin levels were associated with older age, male sex, non-Hispanic Black race, diabetes, lower eGFR, higher albuminuria, increased plasma levels of iron indices, C-terminal fibroblast growth factor 23, and markers of inflammation (high-sensitivity C-reactive protein and interleukin-6). We found no association between plasma hepcidin level and the risk for incident HF or prediabetes/diabetes. However, compared to the middle tertile, the highest hepcidin tertile was independently associated with increased risk for kidney outcomes (hazard ratio 1.19; 95% confidence interval 1.09, 1.30) and atherosclerotic events (hazard ratio 1.34; 95% confidence interval 1.09, 1.64), while the lowest hepcidin tertile was associated with increased risk for all-cause and CV mortality in fully adjusted multivariable models including iron indices and inflammation. CONCLUSION: Both low and high plasma levels of hepcidin are associated with adverse clinical outcomes."}