Plasma levels of acylated and total ghrelin in pediatric patients with chronic kidney disease.
This cross-sectional study set out to compare total and acyl ghrelin levels in children with mild chronic kidney disease (CKD) undergoing conservative treatment (n = 19) with children with end-stage renal disease (ESRD) undergoing hemodialysis (n = 24), and with healthy controls (n = 20). The relationship between ghrelin levels and parameters of renal function, nutritional status, and selective hormones were investigated. ESRD patients had higher total ghrelin levels than those with mild CKD or control individuals. However, acyl ghrelin did not differ between groups, indicating that the excess circulating ghrelin was desacylated. Since desacyl ghrelin has been shown to inhibit appetite, increased levels might contribute to protein-energy wasting in pediatric renal patients. When all 43 renal patients were combined, multiple regression analysis found age and glomerular filtration rate (GFR) to be significant negative predictors of total ghrelin. Acyl ghrelin was influenced negatively by age and positively by energy intake. Acyl to total ghrelin ratio related positively to GFR and energy intake. The results indicate that total but not acyl ghrelin is influenced by low GFR in children with CKD and suggests that ghrelin activation may be impaired in these patients. Since energy intake is a positive predictor of acyl ghrelin, the physiological control of ghrelin secretion appears to be altered in pediatric renal patients.
Naufel
Maria Fernanda Soares
MF
Universidade Federal de São Paulo, Rua Melo Alves, Jardins, São Paulo, SP, Brazil. fenaufel@yahoo.com
Bordon
Milena
M
de Aquino
Talita Marques
TM
Ribeiro
Eliane Beraldi
EB
de Abreu Carvalhaes
João Tomás
JT
D000215:Acylation; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D054439:Ghrelin / Q000097:blood*; D005919:Glomerular Filtration Rate; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D020738:Leptin / Q000097:blood; D008297:Male; D009752:Nutritional Status; D011499:Protein Processing, Post-Translational; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000209:etiology; D006435:Renal Dialysis; D012720:Severity of Illness Index
D015415:Biomarkers; C515349:GHRL protein, human; D054439:Ghrelin; D020738:Leptin; C422650:ghrelin, des-n-octanoyl; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I