Document Detail

Anorexia in hemodialysis patients: the possible role of des-acyl ghrelin.
MedLine Citation:
PMID:  17556836     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Anorexia is frequently found in end-stage renal disease and is a reliable predictor of morbidity and mortality in hemodialysis (HD) patients. The pathogenesis of anorexia is complex and the appetite-modulating hormone ghrelin could be involved. Two forms of circulating ghrelin have been described: acylated ghrelin (<10% of circulating ghrelin) which promotes food intake, and des-acyl ghrelin which induces a negative energy balance. The aim of this cross-sectional study is to clarify whether anorexia and body weight change in HD patients relate to plasma des-acyl ghrelin levels. METHODS: 34 HD patients and 15 healthy controls were studied. The presence of anorexia was assessed by a questionnaire. Serum des-acyl ghrelin was measured in HD patients and in 15 body mass index-, sex- and age-matched controls by ELISA. Energy intake was assessed by a 3-day dietary diary, and fat-free mass (FFM) was evaluated by body impedance analysis. Data have been statistically analyzed and are presented as mean +/- SD. RESULTS: 14 patients (41%) were found to be anorexic, and 20 patients (59%) non-anorexic. Energy intake (kcal/day) was significantly lower in anorexic than in non-anorexic patients (1,682 +/- 241 vs. 1,972.50 +/- 490; p < 0.05). FFM (%) was lower in anorexic than in non-anorexic patients (65.8 +/- 4.4 vs. 70.9 +/- 8.7; p = 0.05). Plasma des-acyl ghrelin levels (fmol/ml) were significantly higher in HD patients than in controls (214.88 +/- 154.24 vs. 128.93 +/- 51.07; p < 0.05), and in anorexic HD patients than in non-anorexic (301.7 +/- 162.4 vs. 159.1 +/- 115.5; p < 0.01). CONCLUSION: Anorexia is highly prevalent among HD patients and des-acyl ghrelin could be involved in its pathogenesis.
Maurizio Muscaritoli; Alessio Molfino; Maria Grazia Chiappini; Alessandro Laviano; Thomas Ammann; Paola Spinsanti; Daniela Melchiorri; Akio Inui; Filippo Alegiani; Filippo Rossi Fanelli
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Publication Detail:
Type:  Journal Article     Date:  2007-06-08
Journal Detail:
Title:  American journal of nephrology     Volume:  27     ISSN:  1421-9670     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  2007  
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-09-19     Revised Date:  2008-05-13    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  360-5     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Department of Clinical Medicine, University La Sapienza, Rome, Italy.
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MeSH Terms
Anorexia / blood*,  etiology
Case-Control Studies
Cross-Sectional Studies
Kidney Failure, Chronic / blood*,  complications,  therapy
Middle Aged
Peptide Hormones / blood*
Renal Dialysis / adverse effects*
Reg. No./Substance:
0/Ghrelin; 0/Peptide Hormones; 0/ghrelin, des-n-octanoyl
Comment In:
Nephrol Dial Transplant. 2007 Dec;22(12):3673-4   [PMID:  17890753 ]

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