title: Appetite-regulating hormones in chronic kidney disease patients.
abstract: OBJECTIVE
  Inflammation and loss of appetite is the most common problem in patients with chronic kidney disease (CKD). This comparative cross-sectional study aimed to characterize the changes in circulating levels of ghrelin, obestatin, leptin, all of which have an effect on food intake, and proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) in patients with CKD who were undergoing different treatments.
  
  
  METHODS
  Study participants included 36 patients who had undergone hemodialysis (body mass index [BMI]: 22.3 ± 4.17 kg/m(2)); 41 who had undergone peritoneal dialysis (BMI: 23.5 ± 3.10 kg/m(2)), 30 with early stage CKD (BMI: 24.4 ± 3.32 kg/m(2)), and 31 healthy subjects (24.3 ± 2.14 kg/m(2)). The patients with CKD were kept under a standard diet with restricted salt, potassium, and protein intake.
  
  
  METHODS
  Levels of leptin, acylated ghrelin, obestatin, TNF-α, and IL-6 were measured by commercially available enzyme-linked immunosorbent assay kits. Total nitrite/nitrate was analyzed using colorimetric assay kit.
  
  
  RESULTS
  Significantly high leptin levels, accompanied by low acylated ghrelin levels, were observed in patients with CKD. Maintenance dialysis did not affect these levels. TNF-α and IL-6 levels were significantly higher in CKD patients than in healthy subjects, the highest being in dialysis patients. Obestatin levels were relatively low in patients who had undergone hemodialysis.
  
  
  CONCLUSIONS
  Low acyl-ghrelin levels, accompanied with high levels of TNF-α and IL-6 may be involved in the loss of appetite and poor nutritional status in CKD patients.
authors.affiliation: Medical Laboratory Programme, Medical Services Training School, Istanbul University, Cerrahpasa, Istanbul, Turkey.
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Oner-Iyidogan
authors.forename: Figen
authors.initials: F
authors.lastname: Gurdol
authors.forename: Hikmet
authors.initials: H
authors.lastname: Kocak
authors.forename: Pernur
authors.initials: P
authors.lastname: Oner
authors.forename: Pinar
authors.initials: P
authors.lastname: Cetinalp-Demircan
authors.forename: Yasar
authors.initials: Y
authors.lastname: Caliskan
authors.forename: Taner
authors.initials: T
authors.lastname: Kocak
authors.forename: Aydin
authors.initials: A
authors.lastname: Turkmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001066:Appetite; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D001068:Feeding and Eating Disorders / Q000150:complications; D005260:Female; D054439:Ghrelin / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000150:complications; D015850:Interleukin-6 / Q000032:analysis; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D020738:Leptin / Q000032:analysis / Q000378:metabolism*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009566:Nitrates / Q000032:analysis; D009573:Nitrites / Q000032:analysis; D009752:Nutritional Status; D006435:Renal Dialysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D055815:Young Adult
chemical_list: D054439:Ghrelin; D015850:Interleukin-6; D020738:Leptin; D009566:Nitrates; D009573:Nitrites; D014409:Tumor Necrosis Factor-alpha