Effect of HDF on obestatin level as a marker of malnutrition in hemodialysis patients

Background Obestatin is a proposed anorexigenic gut peptide, 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 to evaluate the possible participation of this hormone in protein energy wasting in maintenance HD patients. The objective of this study is to assay the effect of hemodiafiltration (HDF) on serum obestatin level in prevalent HD patients. Patients and methods This cross-sectional study included 40 prevalent HD patients: (20 patients maintained on high-flux HD) and (20 patients maintained on online HDF), 20 healthy individuals served as controls. Full history in detail was taken and a full clinical examination was done, with malnutrition-inflammation score calculation. Routine laboratory analysis was performed also, with evaluation of serum obestatin level pre and post session by enzyme linked immunosorbent assay. Results BMI was statistically significantly lower in HD and HDF groups compared with the control group ( P = 0.002). Obestatin level was significantly higher predialysis in HD and HDF groups in comparison to the control group ( P value < 0.000), with a higher obestatin reduction ratio post sessions in HDF group than HD group. ( P value < 0.001). Obestatin concentration negatively correlated with weight, height, BMI, low-density lipoprotein, and S iron ( P value < 0.05), while positively correlated with creatinine, urea, uric acid, and C-reactive protein ( P value < 0.05). Regression analysis showed that serum obestatin was independently affected by serum low-density lipoprotein level. Conclusion The current observational data suggests that obestatin hormone was elevated in prevalent HD patients (high-flux HD group and online HDF group) than control group, this hormone might be a marker of inflammation and dyslipidemia. Obestatin removal was better by online HDF than high flux HD.