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Normal regulation of elevated plasma ghrelin concentrations in dialysis patients

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Summary

Background

Chronic renal failure is often associated with malnutrition, and malnourished patients are subject to increased morbidity and mortality. Therefore plasma concentrations of the stomach-derived peptide hormone ghrelin, which has been shown to exert potent GH-releasing and appetite-stimulating effects, were determined and correlated with nutritional parameters.

Methods

Twenty-four patients (15 male, 9 female) undergoing hemodialysis (HD) were studied. In addition, six patients were studied before and one hour after ingestion of a meal and five were studied immediately before and at the end of the dialysis session.

Results

Chronic renal insufficiency was associated with significantly elevated ghrelin levels (320.1±57 fmol/mL vs. 75.6±12.4 fmol/mL in controls; p<0.007). Plasma ghrelin concentrations were also significantly higher in the 16 normal-weight patients than in the eight overweight or obese patients (399.6±76.3 fmol/mL vs. 161.1±41.3 fmol/mL; p<0.03). Ingestion of food induced a decrease in five out of six patients tested (mean 242.3±66.5 fmol/mL vs. 186±30.7 fmol/mL; n.s.). HD also resulted in a significant decrease of elevated ghrelin concentrations: ghrelin was in the normal range at the end of HD in four of the five patients tested. Plasma ghrelin concentrations did not correlate with nutritional parameters except for cholinesterase which was negatively correlated to ghrelin.

Conclusion

Plasma ghrelin concentrations are elevated in HD. The fact that ghrelin concentrations are higher in normal-weight than in overweight or obese HD patients and suppressed after ingestion of a meal suggests that the regulation of ghrelin release is retained in HD patients, albeit shifted to a higher level.

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Authors and Affiliations

  1. Clinical Division of Endocrinology and Metabolism, University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Adele Schmidt, Christina Maier, Michaela Riedl, Harald Kotzmann & Anton Luger M.D.

  2. Clinical Division of Nephrology and Dialysis, Department of Medicine III, University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Veronika Fabrizii & Alice Schmidt

  3. Ludwig Boltzmann Institute for Experimental Endocrinology, Vienna, Austria

    Georg Geyer & Anton Luger M.D.

Authors
  1. Adele Schmidt
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  2. Veronika Fabrizii
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  3. Christina Maier
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  4. Michaela Riedl
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  5. Alice Schmidt
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  6. Harald Kotzmann
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  7. Georg Geyer
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  8. Anton Luger M.D.
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Correspondence to Anton Luger M.D..

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Schmidt, A., Fabrizii, V., Maier, C. et al. Normal regulation of elevated plasma ghrelin concentrations in dialysis patients. Wien Klin Wochenschr 116, 235–239 (2004). https://doi.org/10.1007/BF03041053

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  • DOI: https://doi.org/10.1007/BF03041053

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