Trial reportPediatric nephrology (Berlin, Germany)2018
Unacylated ghrelin and obestatin: promising biomarkers of protein energy wasting in children with chronic kidney disease.
Trial report in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Energy and protein requirements for children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce.Pediatric nephrology (Berlin, Germany) · 2020Guideline
- Malnutrition and protein energy wasting are associated with severity and progression of pediatric chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2024Article
- Endocrine, genetic, and microbiome nexus of obesity and potential role of postbiotics: a narrative review.Eating and weight disorders : EWD · 2023Review
- Measurement of Ghrelin as a Marker of Appetite Dysregulation in Cats with and without Chronic Kidney Disease.Veterinary sciences · 2023Article
- Pathophysiological mechanisms leading to muscle loss in chronic kidney disease.Nature reviews. Nephrology · 2022Review
- Muscle-bone axis in children with chronic kidney disease: current knowledge and future perspectives.Pediatric nephrology (Berlin, Germany) · 2021Review
- Predicational ability of phase angle on protein energy wasting in kidney disease patients with renal replacement therapy: A cross-sectional study.Food science & nutrition · 2021Article
- Leptin and ghrelin in chronic kidney disease: their associations with protein-energy wasting.Pediatric nephrology (Berlin, Germany) · 2018Article
- Expanded haemodialysis: news from the field.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Review
- Unacylated ghrelin and obestatin in pediatric CKD: are they important in protein energy wasting?Pediatric nephrology (Berlin, Germany) · 2018Article
- Ghrelin Levels and Decreased Kidney Function in Patients with Early Stages of Chronic Kidney Disease Against the Background of Obesity.Journal of medicine and lifeArticle
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImpairment in orexigenic/anorexigenic hormone balance may be key in the pathogenesis of protein energy wasting in children with chronic kidney disease (CKD). Measurement of ghrelin and obestatin concentrations in children with CKD would help assess the potential contribution of these hormones to uremic protein energy wasting.
methodsThis was a cross-sectional case-control study. Acylated and unacylated ghrelin and obestatin were measured in 42 children on conservative treatment (CT), 20 children on hemodialysis, 48 pediatric renal transplant (RTx) recipients and 43 controls (CTR) (mean age 11.9, range 5-20 years). Weight, height and bicipital, tricipital, subscapular and suprailiac folds were measured, and the body mass index-standard deviation score (BMI-SDS), percentage of fat mass and fat-free mass were calculated. Urea and creatinine were measured and the glomerular filtration rate (GFR) calculated.
resultsUnacylated ghrelin level was higher in patients than controls (p = 0.0001), with the highest levels found in hemodialysis patients (p = 0.001 vs. CKD-CT, p = 0.0001 vs. RTx, p < 0.0001 vs. CTR). Obestatin level was significantly higher in patients on hemodialysis than those on conservative treatment, RTx recipients and controls (p < 0.0001 in each case). Unacylated ghrelin negatively correlated with weight-SDS (p < 0.0001), BMI-SDS (p = 0.0005) and percentage fat mass (p = 0.004) and positively correlated with percentage fat-free mass (p = 0.004). Obestatin concentration negatively correlated with weight-SDS (p = 0.007). Unacylated ghrelin and obestatin concentrations positively correlated with creatinine and urea and inversely with eGFR, even after adjustments for gender, age, puberty and BMI-SDS (p < 0.0001 for each model).
conclusionsUnacylated ghrelin and obestatin, negatively related to renal function, seem to be promising inverse indicators of nutritional status in children with CKD. Potential therapeutic implications in terms of optimization of their removal in patients on hemodialysis could be hypothesized.
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