#3927 AN ANOREXIGENIC HORMONE IN PEDITARIC CKD PATIENTS

Abstract

Abstract Background and Aims Chronic kidney disease (CKD) is a major health problem associated with faltering growth, which is a complex process, where anorexia, inadequate oral intake in addition to disturbed body metabolism play a significant role. Leptin, the anorexigenic hormone that's secreted by fat tissue, and affect appetite, & hence, aids to weigh loss & faltering growth. The present study evaluated serum leptin level, & its relation to growth parameters in pediatric patients with different stages of CKD. Method A cross-sectional study that was conducted on 87 subjects, who were divided equally into groups; CKD stage 5 on regular hemodialysis (CKD5d), & CKD stage 2–4, & age & gender matched controls. Patient with diabetes, infected with hepatitis C virus, & on growth hormone therapies were excluded. Full history taking, assessment of growth parameters using gender & age specific Z-scores of heights, weight & body mass index were done. Fasting serum leptin, calcium, phosphorus, PTH, albumin, total proteins, iron & hemoglobin were measured. Results Our patients had significantly lower growth parameters compared to controls. Hypocalcemia, high PTH, iron deficiency anemia & hypoalbuminemia were significant in CKD2-4 groups compared to other groups. Serum leptin was abnormally high in 12.6% of CKD patients. The median leptin level was comparable between the groups (p = 0.20). Serum leptin hadn’t changed significantly as regards gender, BMI Z-scores, diagnoses, or CKD stage (p = 1.00, 0.379, 0.542, 0.171 respectively). A negative correlation was found between leptin level & CKD duration (r = -0.276, P = 0.036), otherwise, no correlations were found with clinical & laboratory variables. Conclusion Leptin level was not affected by CKD stage & not a useful marker for growth in pediatric CKD patients. Large studies on relationship between leptin & growth is needed.