Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
154 participants
OBSERVATIONAL
2013-01-01
2015-06-30
Brief Summary
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The pathophysiology of PEW in CKD is multifactorial and not yet completely understood. The potential role in uremic PEW of two of hormones involved in orexigenic/anorexigenic balance, ghrelin and obestatin, both derived from the ghrelin gene (GHRL), has been investigated in adults and, less extensively, in children. Aim of our study was to measure AG, UAG and obestatin concentrations in children with CKD and to assess their potential contribution to the development of pediatric uremic PEW.
Detailed Description
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CKD stages were defined using the K/DOQI criteria of the US National Kidney Foundation.
Control subjects were outpatients of the Pediatric Surgery Unit of the Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico - Milan, Italy, aged 1-20 years, who underwent a blood sample collection before a surgical intervention for the treatment of minor diseases that did not impair renal or endocrine function (i.e. phimosis, hydrocele, inguinal hernia).
Biochemical and hormonal parameters Blood samples were collected between 7:00 and 8:00 a.m. after an overnight fast, and before dialysis in CKD-HD patients. Routine biochemical parameters \[creatinine, urea\] were measured in all subjects. Glomerular filtration rate was estimated (eGFR) by the Schwartz formula, with k = 0.413, as appropriate for standardized creatinine.
In all subjects, plasma AG and UAG concentrations were measured by the Human Acylated / Unacylated Ghrelin ELISA kit (BioVendor, Laboratorni Medicina a.s., Brno, Czech Republic) according to manufacture procedures, and AG/UAG ratio was calculated. Serum obestatin concentrations were determined using the Human Obestatin ELISA kit (BioVendor, Laboratorni Medicina a.s., Brno, Czech Republic).
Conditions
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Keywords
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Study Design
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COHORT
CROSS_SECTIONAL
Study Groups
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CKD-CT
subjects with CKD stages II-V under conservative treatment
none intervention
it is not an interventional study; it is an observational study
CKD-HD
subjects with CKD stage V on hemodialysis
none intervention
it is not an interventional study; it is an observational study
RTx renal transplant
renal transplant recipients
none intervention
it is not an interventional study; it is an observational study
Controls
control subjects
none intervention
it is not an interventional study; it is an observational study
Interventions
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none intervention
it is not an interventional study; it is an observational study
Eligibility Criteria
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Inclusion Criteria
* the RTx patients should have received renal transplantation at least 6 months before
Exclusion Criteria
* the presence of neurologic disability or syndromic diseases affecting per se food intake
* for controls: they should have no history of chronic diseases and should not receive any medication. They should be on unrestricted diet.
5 Years
20 Years
ALL
No
Sponsors
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Azienda Ospedaliero Universitaria Maggiore della Carita
OTHER
Responsible Party
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Flavia Prodam
Clinical Professor
Principal Investigators
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Flavia Prodam, MD
Role: STUDY_DIRECTOR
Università del Piemonte Orientale - Novara
References
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Mak RH, Ikizler AT, Kovesdy CP, Raj DS, Stenvinkel P, Kalantar-Zadeh K. Wasting in chronic kidney disease. J Cachexia Sarcopenia Muscle. 2011 Mar;2(1):9-25. doi: 10.1007/s13539-011-0019-5. Epub 2011 Mar 16.
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. Nephrol Dial Transplant. 2004 Aug;19(8):2095-100. doi: 10.1093/ndt/gfh313. Epub 2004 Jun 8.
Iglesias P, Diez JJ, Fernandez-Reyes MJ, Codoceo R, Alvarez-Fidalgo P, Bajo MA, Aguilera A, Selgas R. Serum ghrelin concentrations in patients with chronic renal failure undergoing dialysis. Clin Endocrinol (Oxf). 2006 Jan;64(1):68-73. doi: 10.1111/j.1365-2265.2005.02418.x.
Barazzoni R, Zanetti M, Stulle M, Mucci MP, Pirulli A, Dore F, Panzetta G, Vasile A, Biolo G, Guarnieri G. Higher total ghrelin levels are associated with higher insulin-mediated glucose disposal in non-diabetic maintenance hemodialysis patients. Clin Nutr. 2008 Feb;27(1):142-9. doi: 10.1016/j.clnu.2007.06.013. Epub 2007 Sep 12.
Jarkovska Z, Hodkova M, Sazamova M, Rosicka M, Dusilova-Sulkova S, Marek J, Justova V, Lacinova Z, Haluzik M, Haas T, Krsek M. Plasma levels of active and total ghrelin in renal failure: a relationship with GH/IGF-I axis. Growth Horm IGF Res. 2005 Dec;15(6):369-76. doi: 10.1016/j.ghir.2005.07.004. Epub 2005 Sep 28.
Yoshimoto A, Mori K, Sugawara A, Mukoyama M, Yahata K, Suganami T, Takaya K, Hosoda H, Kojima M, Kangawa K, Nakao K. Plasma ghrelin and desacyl ghrelin concentrations in renal failure. J Am Soc Nephrol. 2002 Nov;13(11):2748-52. doi: 10.1097/01.asn.0000032420.12455.74.
Mafra D, Guebre-Egziabher F, Cleaud C, Arkouche W, Mialon A, Drai J, Fouque D. Obestatin and ghrelin interplay in hemodialysis patients. Nutrition. 2010 Nov-Dec;26(11-12):1100-4. doi: 10.1016/j.nut.2009.09.003. Epub 2009 Dec 16.
Buscher AK, Buscher R, Hauffa BP, Hoyer PF. Alterations in appetite-regulating hormones influence protein-energy wasting in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2010 Nov;25(11):2295-301. doi: 10.1007/s00467-010-1588-9. Epub 2010 Jul 6.
Nusken KD, Groschl M, Rauh M, Stohr W, Rascher W, Dotsch J. Effect of renal failure and dialysis on circulating ghrelin concentration in children. Nephrol Dial Transplant. 2004 Aug;19(8):2156-7. doi: 10.1093/ndt/gfh310. No abstract available.
Arbeiter AK, Buscher 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 Feb;24(2):643-6. doi: 10.1093/ndt/gfn529. Epub 2008 Sep 22.
Monzani A, Perrone M, Prodam F, Moia S, Genoni G, Testa S, Paglialonga F, Rapa A, Bona G, Montini G, Edefonti A. Unacylated ghrelin and obestatin: promising biomarkers of protein energy wasting in children with chronic kidney disease. Pediatr Nephrol. 2018 Apr;33(4):661-672. doi: 10.1007/s00467-017-3840-z. Epub 2017 Nov 18.
Other Identifiers
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396/2011 bis
Identifier Type: -
Identifier Source: org_study_id