Effect of Hemodiafiltration on Obestatin Hormone Level as a Marker of Malnutrition in Prevalent Hemodialysis Patients

Abstract Background and Aim Obestatin, is a ghrelin-associated peptide have anorexigenic effect, known as appetite regulatory hormone, we postulated a potential correlation between obestatin level and malnutrition in hemodialysis (HD) patients. Measurement of obestatin concentration in HD patients would help assess the potential contribution of this hormone to uremic protein energy wasting. The purpose of this study was to assay effect of hemodiafiltration (HDF) on serum level of obestatin in HD patients. Patients and Methods We Conducted a cross sectional analytical study of the patients with ESRD undergoing HD recruited from the Department of Nephrology, Ain Shams University hospitals. Serum level of obestatin pre and post sessions was measured using enzyme linked immunosorbent assay (ELISA) in 40 prevalent hemodialysis patients: 20 on high flux HD & 20 on online HDF. 20 healthy individuals served as controls. Full history in details was taken & full clinical examination was done with the calculation of Malnutrition-Inflammation Score (MIS). Routine labs were done as well. Results Anthropometric measurements were significantly lower in HD & HDF groups compared with control group, Obestatin level was significantly higher in HD & HDF groups in comparison to control group. (P value < 0.000), with higher obestatin reduction ratio post sessions in HDF group than HD group. (P value < 0.001). Plasma obestatin concentration were negatively correlated with BMI & S. iron (P value < 0.05), while positively correlated with creatinine, urea, uric acid and CRP (P value < 0.05). Conclusion The current observational data suggests obestatin hormone was elevated in prevalent HD patients than control group & this hormone might be implicated in renal functions and markers of inflammation.