Hepcidin levels rise as a result of the chronic inflammation found in CKD. Hepcidin decreases the amount of iron released from iron stores and absorbed in gut, which contributes to functional iron deficiency. OBJECTIVES: We evaluated the hepcidin role compared to inflammation and parameters of iron in chronic hemodialysis patients. PATIENTS AND METHODS: 86 participants were included and divided into 2 groups, the control group (21 healthy persons), the hemodialysis CKD group (65 patients). The patients received regular erythropoietin therapy before the study. All of them were subjected to thorough history taking and complete clinical examination. CBC, viral hepatitis markers, kidney function tests, serum levels of hepcidin-25, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), high sensitive C-reactive protein (hs-CRP), Transferrin saturation (TSAT), iron, ferritin, and total iron binding capacity (TIBC) were assessed for all subjects. RESULTS: The hemodialysis group had significantly higher serum levels of IL-6, TNF-α, and hs-CRP than the control group. Serum iron and TSAT levels were significantly greater in HD-CKD patients compared to controls, but Hb and TIBC values were significantly lower. When compared to the controls, serum hepcidin-25 was considerably higher in the HD patients. In the patient group, hepcidin showed a positive correlation with serum iron, TSAT, ferritin, TNF-α, hs-CRP, IL-6, blood urea and creatinine and a negative correlation with Hb level and TIBC. Stepwise regression analysis revealed that hepcidin was significantly predicted by Hb, ferritin, TSAT, TNF-α, IL-6 and hs-CRP. Hepcidin and ferritin were significant predictor of functional iron deficiency anemia (AUC=.791, AUC=.724, respectively). Hepcidin levels can be considerably predicted by serum levels of ferritin, iron, IL-6, and hs-CRP. When compared high hepcidin patients to low hepcidin patients, hepcidin, iron, ferritin, IL-6 and hs-CRP were significantly increased while Hb was noticeably decreased. CONCLUSIONS: Serum hepcidin-25 is a reliable biomarker for iron status in HD-CKD patients. Additionally, determining hepcidin in conjunction with markers linked to iron metabolism improves the ability to identify patients who are iron deficient.