Ghada M. El-Kassas
National Research Centre, Egypt
Title: Protein energy wasting in a sample of Egyptian children on regular hemodialys: Relation to anorexigenic hormones
Biography
Biography: Ghada M. El-Kassas
Abstract
Protein energy wasting (PEW) and growth retardation are common problems in pediatric patients with chronic renal failure (CRF). Disturbances in anorexigenic/orexigenic hormonal balance may be key in the pathogenesis of PEW in CRF children. Aim of work: In this study we investigated the association between serum unacylated ghrelin and obestatin (two hormones involved in energy balance) and the nutritional status in a group of Egyptian children with CRF on regular hemodialys.
Subjects & Methods: This case–control study was conducted on fifty CRF children on regular hemodialysis aged (7-15years) who recruited from Nephrology department, Pediatric Hospital, Ain Shams University. Forty age and sex matched healthy children were included as a controls. Full history taking, clinical examination and anthropometric measurements were done. Standard deviation score (SDS) for all measurements were calculated. BMI-SDS, waist-hip ratio (WHR), the percentage of fat mass (FM%) and fat-free mass (FFM%) were calculated. Hemoglobin level, serum urea, creatinine, glucose, cholesterol, triglyceride, HDL, ghrelin and obestatin were measured. Glomerular filtration rate (GFR), the homeostatic model assessment–insulin resistance (HOMA-IR) and LDL were calculated.
Results: Serum unacylated ghrelin and obestatin levels were markedly higher in cases than controls (p < 0.001). Serum unacylated ghrelin and obestatin positively associated with urea and creatinine, and inversely associated with GFR in hemodialysed children (p < 0.001). Obestatin level negatively associated with BMI SDS-score (p< 0.01).Unacylated ghrelin negatively associated with weight SDS-score (p < 0.04), BMI SDS-score (p = 0.03) and percentage fat mass (p< 0.05).
Conclusion: We concluded that measurement of unacylated ghrelin and/ or obestatin is fundamental in hemodialysed children, as both hormones are inversely related to renal function and can be used as an excellent biomarker of nutritional status in hemodialyed children.