Fetuin-A and Ghrelin Levels in Children with End Stage Renal Disease and the Effect of a Single Hemodialysis Session on Them
DOI:
https://doi.org/10.3889/oamjms.2015.081Keywords:
Fetuin-A, acyl ghrelin, hemodialysis, chronic renal failure, childrenAbstract
BACKGROUND: Fetuin-A and ghrelin have been implicated in cardiovascular diseases and mortality among end stage renal disease patients. The exact mechanisms have not been fully elucidated. There is robust data supporting an association between ghrelin and various cardiovascular conditions, and some common processes such as inflammation, oxidative stress, and endoplasmic reticulum stress have been implicated.
AIM: This study was conducted to assay serum fetuin-A and ghrelin in chronic renal failure pediatric patients and to study changes in their level that may occur after a single hemodialysis.
MATERIAL AND METHODS: Forty nine pediatric patients suffering from ESRD on maintenance hemodialysis (HD), 20 patients with chronic renal failure (CRF) not on dialysis and 35 healthy subjects as control group were included. The mean age of the study population was 10.58 ± 3.94, 10.62 ± 3.24 and 10.61 ± 3.97 years respectively. Serum fetuin-A and plasma acyl ghrelin levels were measured by using ELISA method.
RESULTS: The present study revealed that predialysis serum fetuin-A level was significantly increased in pediatric HD patients compared with the normal population, while ghrelin levels were significantly reduced. Furthermore, serum levels of fetuin-A decreased significantly after a single HD session.
CONCLUSION: Our study concluded that fetuin-A and acyl ghrelin may play a role in inflammatory process among HD pediatric patients which may account for cardiovascular insults and mortality but their use as biochemical markers among ESRD pediatric patients have limitations due to wide fluctuations.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Collins AJ, Li SL, Ma JZ, Herzog C. Cardiovascular disease in end-stage renal disease patients. Am J Kidney Dis. 2001; 38: S26–S29. DOI: https://doi.org/10.1053/ajkd.2001.27392
Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 2001; 38: 938–42. DOI: https://doi.org/10.1161/hy1001.096358
Cozzolino M, Brancaccio D, Gallieni M, Slatopolsky E. Pathogenesis of vascular calcification in chronic kidney disease. Kidney Int. 2005; 68: 429–36 DOI: https://doi.org/10.1111/j.1523-1755.2005.00421.x
Westenfeld R, Schäfer C, Krüger T et al. Fetuin-A protects atherosclerotic calcification in CKD. Journal of American Society of Nephrology. 2009; 20(6): 1264–74. DOI: https://doi.org/10.1681/ASN.2008060572
Wajih N, Borras T, Xue W, Hutson SM, Wallin R. Processing and transport of matrix γ-carboxyglutamicacid protein and bone morphogenetic protein-2 in cultured human vascular smooth muscle cells: evidence for an uptake mechanism for serum fetuin. The Journal of Biological Chemistry. 2004; 279(41):43052–60. DOI: https://doi.org/10.1074/jbc.M407180200
Cottone S, Palermo A, Arsena R et al. Relationship of fetuin-A with glomerular filtration rate and endothelial dysfunction in moderate-severe chronic kidney disease. Journal Nephrology. 2010; 23(1):62–9.
Ketteler M, Bongartz P, Westenfeld R et al. Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a cross-sectional study. Lancet. 2003; 361: 827–33. DOI: https://doi.org/10.1016/S0140-6736(03)12710-9
Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growth-hormone releasing acylated peptide from stomach. Nature. 1999; 402: 656- 60. DOI: https://doi.org/10.1038/45230
Gaigai Z, Xinhua Y, Yongfen Qi, Lakshmana P, Jack C, Dongming H, Chaoshu T. Ghrelin and Cardiovascular Diseases. Current Cardiology Reviews. 2010; 6: 62-70. DOI: https://doi.org/10.2174/157340310790231662
Wren AM, Small CJ, Abbott CR, et al. Ghrelin causes hyperphagia and obesity in rats. Diabetes. 2001; 50:2540–47. DOI: https://doi.org/10.2337/diabetes.50.11.2540
Wren AM, Seal LJ, Cohen MA, et al. Ghrelin enhances appetite and increases food intake in humans. Journal of Clinical Endocrinology and Metabolism. 2001; 86:5992–95. DOI: https://doi.org/10.1210/jcem.86.12.8111
Perez-Fontan M, Cordido F, Rodriguez-Carmona A, Peteiro J, Garcia-Naveiro R, Garcia-Buela J. Plasma ghrelin levels in patients undergoing haemodialysis and peritoneal dialysis. Nephrology Dialysis Transplantation. 2004; 19(8):2095–100. DOI: https://doi.org/10.1093/ndt/gfh313
Szczepańska M, Szprynger K, Mazur B, Zwolińska D, Kiliś-Pstrusińska K, Makulska I. Plasma ghrelin levels in children with chronic renal failure on peritoneal dialysis. Perit Dial Int. 2007; 27(1):61-6. DOI: https://doi.org/10.1177/089686080702700114
Oikawa O, Higuchi T, Yamazaki T, Yamamoto C, Fukuda N, Matsumoto K. Evaluation of serum fetuin-A relationships with biochemical parameters in patients on hemodialysis. Clin Exp Nephrol. 2007;11:304-8. DOI: https://doi.org/10.1007/s10157-007-0499-y
Haddad M, Tajbakhsh R, Farajollahi M, Qorbani M, Besharat S, Joshaghani HR. Association of Serum Fetuin-A and Biochemical Parameters in Hemodialysis Patients. Saudi J Kidney Dis Transpl. 2014;25(4):769-773. DOI: https://doi.org/10.4103/1319-2442.134993
Ziółkowska H, Wojnar J, Pańczyk-Tomaszewska M, Roszkowska-Blaim M. [Fetuin A in children with renal diseases]. Przegl Lek. 2006;63 Suppl 3:54-6.
Schaible J, Wigger M, Staude H, Drueckler E, Kundt G, Haffner D, Fischer DC. Serum fetuin-A and vitamin D in children with mild-to-severe chronic kidney disease: a cross-sectional study. Nephrol Dial Transplant. 2012; 27(3):1107-13. DOI: https://doi.org/10.1093/ndt/gfr382
Kis E, Cseprekál O, BÃró E, Kelen K, Ferenczi D, Kerti A, Szabó AJ, Szabó A, Reusz GS. Effects of bone and mineral metabolism on arterial elasticity in chronic renal failure. Pediatr Nephrol. 2009;24(12):2413-20. DOI: https://doi.org/10.1007/s00467-009-1292-9
Shroff RC, Shah V, Hiorns MP, Schoppet M, Hofbauer LC, Hawa G, Schurgers LJ, Singhal A, Merryweather I, Brogan P, Shanahan C, Deanfield J, Rees L. The circulating calcification inhibitors, fetuin-A and osteoprotegerin, but not Matrix Gla protein, are associated with vascular stiffness and calcification in children on dialysis. Nephrol Dial Transplant. 2008; 23 (10) 3263-71. DOI: https://doi.org/10.1093/ndt/gfn226
Nessim IG, Abd el Wahab A, Madani HA, Waked E, Abd el Khalek A, Mabrouk K. Evaluation of serum osteoprotegerin and fetuin A levels in Egyptian patients with chronic kidney disease. Comparative Clinical Pathology. 2011; 20(5): 421-25. DOI: https://doi.org/10.1007/s00580-011-1281-9
Ix JH, Chertow GM, Shlipak MG, Brandenburg VM, Ketteler M, Whooley MA. Fetuin-A and kidney function in persons with coronary artery disease--data from the Heart and Soul Study. Nephrol Dial Transplant. 2006;21(8):2144-51. DOI: https://doi.org/10.1093/ndt/gfl204
Kayser C , Mahmut IY , Mutlu S , Erdinc C , Selim K , Alper S , Tayfun Eyileten, Mujdat Y , Yusuf O , Mustafa T , Abdulgaffar V , Alp Ikizler T, Peter Sl, Bengt L. Serum Fetuin-A Concentration and Endothelial Dysfunction in Chronic Kidney Disease. Nephron Clin Pract. 2008;108(3):233-40. DOI: https://doi.org/10.1159/000120209
Cottone S, Nardi E, Mulè G, et al. Association between biomarkers of inflammation and left ventricular hypertrophy in moderate chronic kidney disease. Clin Nephrol. 2007;67:209-216. DOI: https://doi.org/10.5414/CNP67209
Ciaccio M, Bivona G, Di Sciacca R, Iatrino R, Di Natale E, Li Vecchi M, Bellia C. Changes in serum fetuin-A and inflammatory markers levels in end-stage renal disease (ESRD): effect of a single session haemodialysis. Clin Chem Lab Med. 2008;46(2):212-4. DOI: https://doi.org/10.1515/CCLM.2008.041
Dusilová S S, Kalousová M, Mistrik E, Bláha V, Bednárová V, Hájková B, Sulek S, Moucka P, Andrys C, Sobotka L. Fetuin-A and hemodialysis. Selected Abstracts / Nutrition 2010; 26: 345–48. DOI: https://doi.org/10.1016/j.nut.2009.11.004
Reinehr T, Roth CL. Fetuin-A and Its Relation to Metabolic Syndrome and Fatty Liver Disease in Obese Children Before and After Weight Loss. The Journal of Clinical Endocrinology & Metabolism. 2008;93(11):4479-85. DOI: https://doi.org/10.1210/jc.2008-1505
Safranek R, Kubisova M, Habanova L, Moucka P, Visek J, Kalousova M, Merta M, Sobotka L, Sulkova SD. Effects of hemodialysis on serum Fetuin-A levels. Kidney Res Clin Pract. 2012; 31 A70. DOI: https://doi.org/10.1016/j.krcp.2012.04.537
Lai HL, Kartal J, Mitsnefes M. Hyperinsulinemia in pediatric patients with chronic kidney disease: The role of tumor necrosis factor-alpha. Pediatr Nephrol. 2007; 22:1751-1756. DOI: https://doi.org/10.1007/s00467-007-0533-z
Lindblad YT, Axelsson J, Bárány P, et al. Hyperinsulinemia and insulin resistance, early cardiovascular risk factors in children with chronic kidney disease. Blood Purif. 2008;26:518-525. DOI: https://doi.org/10.1159/000167799
Tsirpanlis G, Bagos P, Ioannou D, Bleta A, et al. The variability and accurate assessment of microinflammation in haemodialysis patients. Nephrol Dial Transplant. 2004; 19:150–157. DOI: https://doi.org/10.1093/ndt/gfg486
LaClair R, O'Neal K, Ofner S, Sosa MJ, Labarrere CA, Moe SM. Precision of biomarkers to define chronic inflammation in CKD. Am J Nephrol. 2008;28(5):808-12. DOI: https://doi.org/10.1159/000135692
Yoshimoto A, Mori K, Sugawara A et al. Plasma ghrelin and desacyl ghrelin concentrations in renal failure. J Am Soc Nephrol. 2002;13: 2748–2752. DOI: https://doi.org/10.1097/01.ASN.0000032420.12455.74
Currie PJ, Mirza A, Fuld R et al. Ghrelin is an orexigenic and metabolic signalling peptide in the arcuate and paraventricular nuclei. Am J Physiol Regul Integr Comp Physiol. 2005; 289: 353–358. DOI: https://doi.org/10.1152/ajpregu.00756.2004
Tschöp M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents. Nature. 2000; 407: 908–913. DOI: https://doi.org/10.1038/35038090
Cheung WW, Mak RH. Ghrelin and its analogues as therapeutic agents for anorexia and cachexia in end-stage renal disease. Kidney Int. 2009;76(2):135-7. DOI: https://doi.org/10.1038/ki.2009.74
Deboer MD. The use of ghrelin and ghrelin receptor agonists as a treatment for animal models of disease: efficacy and mechanism. Curr Pharm Des. 2012;18(31):4779-99. DOI: https://doi.org/10.2174/138161212803216951
Wynne K, Giannitsopoulou K, Small CJ, Patterson M, Frost G, Ghatei MA, et al. Subcutaneous ghrelin enhances acute food intake in malnourished patients who receive maintenance peritoneal dialysis: a randomized, placebo-controlled trial. J Am Soc Nephrol. 2005; 16:2111–18. DOI: https://doi.org/10.1681/ASN.2005010039
Arbeiter AK, Büscher R, Petersenn S, Hauffa BP, Mann K, Hoyer PF. Ghrelin and other appetite-regulating hormones in paediatric patients with chronic renal failure during dialysis and following kidney transplantation. Nephrol Dial Transplant. 2009; 24: 643–646. DOI: https://doi.org/10.1093/ndt/gfn529
Ayala ER, Pecoits-Filho R, Heimb¨urger O et al. Association between plasma ghrelin levels and body composition in end-stage renal disease: a longitudinal study. Nephrol Dial Transplant. 2004; 19: 421–426. DOI: https://doi.org/10.1093/ndt/gfg559
Nüsken KD, Gröschl M, Rauh M, Stöhr W, Rascher W, Dötsch J. Effect of renal failure and dialysis on circulating ghrelin concentration in children. Nephrol Dial Transplant. 2004; 19:2156–7. DOI: https://doi.org/10.1093/ndt/gfh310
41. Naufel MF1, Bordon M, de Aquino TM, Ribeiro EB, de Abreu Carvalhaes JT. Plasma levels of acylated and total ghrelin in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2010; 25(12):2477-82. DOI: https://doi.org/10.1007/s00467-010-1628-5
Büscher AK, Büscher R, Hauffa BP, Hoyer PF. Alterations in appetite-regulating hormones influence protein-energy wasting in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2010;25(11):2295-301. DOI: https://doi.org/10.1007/s00467-010-1588-9
Montazerifar F, Karajibani M, Gorgij F, Akbari O. Malnutrition Markers and Serum Ghrelin Levels in Hemodialysis Patients. International Scholarly Research Notices. 2014;765895:5. DOI: https://doi.org/10.1155/2014/765895
Barros Ade F, Moraes C, Pinto MB, Lobo JC, Mafra D. Is there association between acyl-ghrelin and inflammation in hemodialysis patients? J Bras Nefrol. 2013;35(2):120-6. DOI: https://doi.org/10.5935/0101-2800.20130020
Eftekhari MH, Ranjbar-Zahedani M, Basiratnia M, Rezaianzadeh A, Faghih S. Comparison of Appetite-regulating Hormones and Body Composition in Pediatric Patients in Predialysis Stage of Chronic Kidney Disease and Healthy Control Group. IJMS. 2015; 40(1):27-33.
Iglesias P, Diez JJ, Fernandez-Reyes MJ, Codoceo R, Alvarez-Fidalgo P, Bajo MA, et al. Serum ghrelin concentrations in patients with chronic renal failure undergoing dialysis. Clin Endocrinol. 2006; 64:68–73. DOI: https://doi.org/10.1111/j.1365-2265.2005.02418.x
Rafael R, Aguilera A, Cirugeda A, Sansone G, Codoceo R, Bajo MA, et al. Ghrelin plasma levels and appetite in peritoneal dialysis patients [Abstract]. Perit Dial Int. 2004; 24(Suppl 2):S24.
Jarkovska Z, Hodkova M, Sazamova M, Rosicka M, Dusilova-Sulkova S, Marek J, et al. Plasma levels of active and total ghrelin in renal failure: a relationship with GH/IGF-I axis. Growth Horm IGF Res. 2005; 15:369–76. DOI: https://doi.org/10.1016/j.ghir.2005.07.004
Tschop M, Wawarta R, Riepl RL, Friedrich S, Bidlingmaier M, Landgraf R, et al. Post-prandial decrease of circulating human ghrelin levels. J Endocrinol Invest. 2001; 24:19–21. DOI: https://doi.org/10.1007/BF03351037
Mak RH, Cheung W, Purnell J. Ghrelin in chronic kidney disease: Too much or too little? Peritoneal Dialysis International. 2007; 27:51–55. DOI: https://doi.org/10.1177/089686080702700112
Downloads
Published
How to Cite
Issue
Section
License
http://creativecommons.org/licenses/by-nc/4.0
