Severity of Gastric Mucosal Atrophy Is the Major Determinant of Plasma Ghrelin Level in Hemodialysis Patients.

Background: Ghrelin, an orexigenic hormone, has multiple favorable functions including protein anabolism enhancement, anti-inflammatory actions, and cardiovascular protection. A low plasma ghrelin level is associated with increased mortality in patients treated with hemodialysis (HD). However, it is...

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Publicado en:American Journal of Nephrology Vol. 44; no. 3; pp. 224 - 234
Autores principales: Sakao, Yukitoshi, Sugimoto, Mitsushige, Ichikawa, Hitomi, Sahara, Shu, Tsuji, Takayuki, Ohashi, Naro, Kato, akihiko, Fujigaki, Yoshihide, Sugimoto, Ken, Furuta, Takahisa, Sakao, Tadashi, Yasuda, Hideo
Formato: research tables/charts Journal Article
Publicado: Karger AG Sep2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2016
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        atl: Severity of Gastric Mucosal Atrophy Is the Major Determinant of Plasma Ghrelin Level in Hemodialysis Patients.
      aug:
        au:
          Sakao, Yukitoshi
          Sugimoto, Mitsushige
          Ichikawa, Hitomi
          Sahara, Shu
          Tsuji, Takayuki
          Ohashi, Naro
          Kato, akihiko
          Fujigaki, Yoshihide
          Sugimoto, Ken
          Furuta, Takahisa
          Sakao, Tadashi
          Yasuda, Hideo
        affil: Hamana Clinic, Hamamatsu
      sug:
        subj:
          Helicobacter Infections Blood
          Gastric Mucosa Pathology
          Renal Insufficiency, Chronic Therapy
          Ghrelin Blood
          Helicobacter Pylori
          Atrophy Blood
          Aged, 80 and Over
          Helicobacter Infections Complications
          Middle Age
          Creatinine Blood
          Breath Tests
          Renal Insufficiency, Chronic Complications
          Renal Insufficiency, Chronic Blood
          Serum Albumin Metabolism
          Atrophy Microbiology
          Enzymes Blood
          Hemodialysis
          Atrophy
          Gastroscopy
          Aged
          Severity of Illness Indices
          Helicobacter Infections Diagnosis
          Age Factors
          Human
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
      ab: Background: Ghrelin, an orexigenic hormone, has multiple favorable functions including protein anabolism enhancement, anti-inflammatory actions, and cardiovascular protection. A low plasma ghrelin level is associated with increased mortality in patients treated with hemodialysis (HD). However, it is unclear whether the plasma ghrelin level in HD patients correlates with the severity of gastric mucosal atrophy and Helicobacter pylori status.Methods: Seventy-eight maintenance HD patients and 51 non-dialysis patients with chronic kidney disease were evaluated for severity of gastric mucosal atrophy by gastroduodenoscopy and for H. pylori status using an anti-H. pylori-antibody and rapid urease test. Plasma acyl and des-acyl ghrelin levels were measured and their associations with relevant clinical parameters were investigated.Results: Des-acyl ghrelin level in HD patients was significantly higher than that in patients with kidney function preserved. Although acyl and des-acyl ghrelin levels were similar between current H. pylori positive and negative HD patients, both levels decreased significantly with the progress of endoscopic gastric mucosal atrophy in HD patients. Serum pepsinogen (PG) I level and PG I/II ratio decreased significantly according to the severity of atrophy in HD patients and positively significantly correlated with both ghrelin levels. Multiple regression analysis showed significant positive correlations between acyl ghrelin and PG I levels (β = 0.738, p < 0.001) and significant negative correlations between ghrelin and age, albumin, and creatinine levels.Conclusions: Gastric atrophy is the major determinant of ghrelin level in HD patients. Management practices, such as H. pylori eradication, before advanced atrophy may be required to prevent the decrease of ghrelin levels and improve the prognosis of HD patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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