Effect of nesfatin-1 on the nutritional status of hemodialysis patients

Abstract

BackgroundNesfatin-1 is considered an anorexigenic peptide that plays an important role in appetite regulation, weight loss, and malnutrition. Although the cause of anorexia in CKD patients is not totally understood, both anorexia and malnutrition are common presentations of chronic kidney disease (CKD) patients who are susceptible to worse outcomes.Our aim of the workTo study the relation of serum nesfatin-1 and its relation to the nutritional status of end-stage renal disease (ESRD), who are maintained on regular hemodialysis. Patients and methodsA total of 60 ESRD patients are maintained on regular hemodialysis, and apparently healthy thirty persons (control group) were included in this study. Those included represented 45 males and 45 females with an age range from 19 to 68 years old. Based on malnutrition inflammation score (MIS), we had three groups, the first & second group, each included 30 ESRD patients maintained on regular HD without & with malnutrition respectively. 3rd group included 30 apparently healthy control persons; all subjects were exposed to full history, clinical examination, MIS questioner, and lab. Tests in the form of Complete blood count, liver function test, Kidney Function test, s.Calcium, Phosphrus, Parathyroid hormone, iron profile, C reactive protein titer, interleukin 6, and serum nesfatin 1. ResultsThere were significant increases in s. nesfatin-1 and CRP levels in groups 1, 2 more than that of the control group, with a significant increase in group 2 in comparison to other groups. Group 2 had a statistically significantly increase of IL6 and MIS when compared to group 1. In group 2. while there was a highly significant positive correlation between nesfatin-1with MIS and IL6, but a significantly negative correlation with BMI, Ph. and serum parathyroid hormone. In group 1, while there was a highly significant positive correlation between nesfatin-1with MIS and IL6, a significantly positive correlation with duration of dialysis but a significantly negative correlation with ferritin, calcium, and cholesterol. The cutoff level in group1 patients versus group 2 was more than 16.6, with a sensitivity of 56.7% and specificity of 83.3%. In conclusion, s. nesfatin-1 is specific for the detection of malnutrition in hemodialysis patients.