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Leptin and ghrelin in chronic kidney disease: their associations with protein-energy wasting

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Abstract

Background

This study aimed to evaluate plasma concentrations of leptin and total ghrelin in children with chronic kidney disease (CKD) and assess their roles in protein-energy wasting (PEW).

Methods

This study consisted of three different CKD populations [CKD group (20 patients with non-dialysis CKD), dialysis group (39 patients on dialysis), and kidney transplant (KTx) group (35 KTx recipients)] and control group (18 healthy children). Plasma leptin and total ghrelin levels were measured. Multi-frequency bioimpedance analysis was used for the assessment of fat and lean mass. PEW was defined using criteria including body mass, muscle mass, growth, serum albumin level, and protein intake.

Results

While plasma leptin levels did not differ among the study groups, total ghrelin levels were significantly higher in the dialysis group (P < 0.001). Seven dialysis patients (18%) and one CKD patient (5%) but none of the KTx recipients met the criteria of PEW. Dialysis patients with PEW had lower plasma leptin levels compared to their counterparts (P = 0.018); however, total ghrelin levels did not differ between the two groups (P = 0.10). Low leptin level in dialysis patients was independently associated with lower fat mass index (P < 0.001) and lower height-specific SD scores of BMI (P = 0.019).

Conclusions

PEW is prevalent in dialysis patients. Low levels of leptin seem to be associated with PEW. Our result suggests that low leptin levels may be a consequence rather than a cause of PEW. Longitudinal studies are required to investigate this complex relationship between leptin and PEW in pediatric dialysis patients.

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Acknowledgements

This work was supported by Scientific Research Projects Coordination Unit of Istanbul University (project number 35291).

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Istanbul University Cerrahpasa Faculty of Medicine, 34098 Fatih, Istanbul, Turkey

    Nur Canpolat, Lale Sever, Ayse Agbas, Mehmet Tasdemir, Cigdem Oruc & Salim Caliskan

  2. Department of Biochemistry, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey

    Ozlem Balcı Ekmekci

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  1. Nur Canpolat
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  2. Lale Sever
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  3. Ayse Agbas
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  4. Mehmet Tasdemir
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  7. Salim Caliskan
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Correspondence to Nur Canpolat.

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The study protocol was approved by the Ethical Committee of Istanbul University, Cerrahpasa Faculty of Medicine.

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The authors declare that they have no conflicts of interest.

Additional information

This study was presented as a poster in the 50th annual meeting of the European Society for Pediatric Nephrology 2017.

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Canpolat, N., Sever, L., Agbas, A. et al. Leptin and ghrelin in chronic kidney disease: their associations with protein-energy wasting. Pediatr Nephrol 33, 2113–2122 (2018). https://doi.org/10.1007/s00467-018-4002-7

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  • DOI: https://doi.org/10.1007/s00467-018-4002-7

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