Table 3.

Potential role of hepcidin in the diagnosis and management of anemia

Condition	Expected hepcidin levels	Iron variables	Iron therapy strategies	Potential hepcidin therapy
Absolute IDA	Low	Low Tsat and ferritin	PO (or IV if PO poorly tolerated or malabsorbed)	No
Functional iron deficiency (ESA therapy, CKD)	Variable, depending on the severity and etiology of CKD	Low Tsat, variable ferritin	IV or oral if low disease activity	Antagonist (if hepcidin levels not low)
Iron sequestration (AI)	High	Low Tsat, normal to elevated ferritin	IV	Antagonist
Mixed anemia (AI/IDA or AI/functional iron deficiency)	Variable	Low Tsat, low to normal ferritin	IV or oral if low disease activity	Antagonist (if hepcidin levels not low)
Iron-loading anemias (eg, ineffective erythropoiesis)	Low	High Tsat and ferritin	Iron chelation therapy	Agonist
Iron-loading anemias treated with transfusion	Normal to high	High Tsat and ferritin	Iron chelation therapy	Agonist

CKD, chronic kidney disease; PO, by mouth; Tsat, transferrin saturation.