Impact of serum hepcidin levels on the efficacy of daprodustat treatment in patients with chronic kidney disease

Chronic Kidney Disease (CKD) has been recognized as a leading public health problem worldwide, and affects 10-15% of all the global population. It is characterized by a long-term condition which often brings along other health problems, like anemia (where the blood has lower-than-normal levels of healthy red blood cells), which can make people sicker and increase the risk of death as it significantly increases the risk of major adverse cardiovascular events (MACE), such as heart failure.

Daprodustat is a new kind of medicine that might help treat anemia in people with chronic kidney disease. It works by targeting a hormone called hepcidin, which plays a big role in how our bodies use iron. If there is too much hepcidin in the body, this can stop the body absorbing iron from the bloodstream and cause anemia.

However, we don't yet fully understand how the levels of hepcidin in the body can affect health outcomes or how daprodustat works in relation to hepcidin levels.

Two randomized controlled trials (RCTs) looking at anemia in CKD, known as ASCEND-ND and ASCEND-D, demonstrated that hepcidin levels were lower in the group of patients taking daprodustat versus those in the control group.

However, little is known about the prognostic implications of baseline hepcidin levels to predict MACE in patients with CKD. Moreover, the association between baseline hepcidin levels and the efficacy of daprodustat remains poorly understood.

Our study aims to use the data from the ASCEND-ND and ASCEND-D trials to find out two main things: how hepcidin levels and their changes over time might predict health outcomes, and how these levels might influence how well daprodustat works for people with kidney disease.

This study will provide invaluable information regarding the target population who should receive daprodustat, and the clinical implications of hepcidin levels, leading to change in the clinical decision making in patients with CKD.