Perspective, J Nephrol Ren Dis Vol: 7 Issue: 4
Exploring the Impactful Role of Kidneys in Iron Metabolism
Herald Okerdhon*
1Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center-University of Freiburg, Freiburg, Germany
*Corresponding Author: Herald Okerdhon,
Department of General Paediatrics,
Adolescent Medicine and Neonatology, Medical Center-University of Freiburg,
Freiburg, Germany
E-mail: herald.okerdhon12@uniklinik-freiburg.de
Received date: 01 November, 2023, Manuscript No. JNRD-23-123903;
Editor assigned date: 03 November, 2023, PreQC No. JNRD-23-123903 (PQ);
Reviewed date: 20 November, 2023, QC No. JNRD-23-123903;
Revised date: 27 November, 2023, Manuscript No. JNRD-23-123903 (R);
Published date: 04 December, 2023, DOI: 10.4172/2576-3962.1000048
Citation: Okerdhon H (2023) Exploring the Impactful Role of Kidneys in Iron Metabolism. J Nephrol Ren Dis 7:4.
Abstract
Iron is an essential element for various physiological processes in the human body, playing a crucial role in oxygen transport, energy production, and cellular function. While the liver is traditionally recognized as a central player in iron metabolism, the kidneys also play a significant and intricate role in maintaining iron homeostasis. Iron metabolism is a dynamic process involving the absorption, distribution, utilization, and recycling of iron within the body. Dietary iron is absorbed in the duodenum and upper jejunum, and once in circulation, it is bound to transferrin, a protein that transports iron throughout the body. Iron is utilized for the synthesis of hemoglobin and other essential proteins, and any excess iron is stored in the liver, primarily in the form of ferritin. The regulation of iron levels is tightly controlled to prevent deficiencies or excess accumulation, as both can lead to serious health issues.
Description
Iron is an essential element for various physiological processes in the human body, playing a crucial role in oxygen transport, energy production, and cellular function. While the liver is traditionally recognized as a central player in iron metabolism, the kidneys also play a significant and intricate role in maintaining iron homeostasis. This article explores the multifaceted functions of the kidneys in iron metabolism and highlights their essential contributions to overall iron balance.
Iron metabolism is a dynamic process involving the absorption, distribution, utilization, and recycling of iron within the body. Dietary iron is absorbed in the duodenum and upper jejunum, and once in circulation, it is bound to transferrin, a protein that transports iron throughout the body. Iron is utilized for the synthesis of hemoglobin and other essential proteins, and any excess iron is stored in the liver, primarily in the form of ferritin. The regulation of iron levels is tightly controlled to prevent deficiencies or excess accumulation, as both can lead to serious health issues.
Iron reabsorption in the proximal tubules
The kidneys filter large amounts of blood daily, and as part of this filtration process, they reabsorb essential substances, including iron. In the proximal tubules of the kidneys, the majority of filtered iron is reabsorbed back into the bloodstream. This reabsorption process is critical for conserving iron and preventing its unnecessary loss in the urine.
Regulation of hepcidin
Hepcidin, a peptide hormone produced by the liver, is a key regulator of iron homeostasis. It controls the release of iron from macrophages, the absorption of iron in the intestines, and the recycling of iron by the reticuloendothelial system. Importantly, the kidneys contribute to the regulation of hepcidin levels. In conditions of iron excess or inflammation, the kidneys help clear excess hepcidin from the bloodstream, contributing to the modulation of systemic iron levels.
Erythropoiesis and erythroferrone regulation
Erythroferrone, a hormone produced by erythroblasts during red blood cell formation (erythropoiesis), plays a role in iron regulation. The kidneys are involved in the production of erythropoietin, a hormone that stimulates erythroferrone release. Erythroferrone acts to inhibit hepcidin, allowing for increased iron availability during periods of increased red blood cell production. The reticuloendothelial system, including the spleen, liver, and bone marrow, is responsible for recycling iron from senescent red blood cells. The kidneys indirectly influence this process by regulating erythropoiesis through the production of erythropoietin. Efficient iron recycling is crucial for maintaining a steady supply of iron for new red blood cell production.
Clinical implications
Individuals with CKD often experience anemia, characterized by a decreased production of red blood cells. The impaired synthesis of erythropoietin by the kidneys contributes to this anemia. Erythropoietin-stimulated erythroferrone release is reduced, leading to elevated hepcidin levels and decreased iron availability for erythropoiesis. This disruption in iron homeostasis contributes to the development of anemia in CKD patients. Recognizing the kidney's role in iron metabolism is crucial in developing strategies to manage anemia in CKD. Iron supplementation, either orally or intravenously, is often employed to address iron deficiency in these patients. Understanding the complex interplay between the kidneys, hepcidin regulation, and erythropoiesis helps healthcare professionals optimize iron supplementation protocols for better patient outcomes.
Conclusion
The kidneys play a vital and intricate role in maintaining iron homeostasis, contributing to the regulation of hepcidin, erythropoiesis, and iron recycling. This newfound appreciation for the kidney's role in iron metabolism has implications for understanding and managing conditions such as anemia of chronic kidney disease. As research continues to unveil the complexities of iron regulation, it opens doors to innovative therapeutic approaches and personalized interventions to address iron-related disorders and optimize patient care.
