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Plasma levels of acylated and total ghrelin in pediatric patients with chronic kidney disease

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Abstract

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.

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Acknowledgements

The authors thank Professor Thais Cocarelli for statistical analysis. This work was financially sponsored by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES (Brazil).

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Authors and Affiliations

  1. Postgraduate Program in Pediatrics, Universidade Federal de São Paulo, Rua Melo Alves, 55. ap.122, Jardins, CEP: 01417-010, São Paulo, SP, Brazil

    Maria Fernanda Soares Naufel, Milena Bordon & Talita Marques de Aquino

  2. Department of Physiology, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Eliane Beraldi Ribeiro

  3. Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    João Tomás de Abreu Carvalhaes

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  1. Maria Fernanda Soares Naufel
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  2. Milena Bordon
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Correspondence to Maria Fernanda Soares Naufel.

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Naufel, M.F.S., Bordon, M., de Aquino, T.M. et al. Plasma levels of acylated and total ghrelin in pediatric patients with chronic kidney disease. Pediatr Nephrol 25, 2477–2482 (2010). https://doi.org/10.1007/s00467-010-1628-5

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  • DOI: https://doi.org/10.1007/s00467-010-1628-5

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