Leptin in Egyptian Children with CKD: A Single Center Experience.

Document Type : Original Article

Authors

1 Department of Pediatrics, Pediatric Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2 Department of Pediatrics , Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3 Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt.

4 Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt

5 Department of Pediatrics , Faculty of Postgraduate Childhood studies, Ain Shams University, Cairo, Egypt.

Abstract

Introduction: Leptin, is an anorexigenic hormone that’s secreted by fat tissue, & affect appetite.                                          Aim of the study: The present study evaluated serum leptin level, & its relation to growth parameters in pediatric patients with different stages of CKD. 
Methods: a cross-sectional study that was conducted on 87 subjects, who were divided into 3 groups equally; CKD stage 5 on regular hemodialysis (CKD5d), & CKD stage 2-4, & age & gender matched controls. Patient with diabetes, infected with hepatitis C virus, & on growth hormone therapy were excluded. Full history taking, assessment of growth parameters using gender & age specific Z-scores of heights, weight & body mass index were done. Fasting serum leptin, calcium, phosphorus, PTH, albumin, total proteins, iron & hemoglobin were measured. 
Results: Our patients had significantly lower growth parameters compared to controls. Hypocalcemia, high PTH, iron deficiency anemia & hypoalbuminemia were significant in CKD2-4 groups compared to other groups. Serum leptin was abnormally high in 12.6% of CKD patients. The median leptin level was comparable between the groups (p=0.20). Serum leptin hadn’t changed significantly as regards gender, BMI Z-scores, diagnoses, or CKD stage (p= 1.00, 0.379, 0.542, 0.171 respectively). A negative correlation was found between leptin level & CKD duration (r = -0.276, P = 0.036), otherwise, no correlations were found with clinical & laboratory variables. 
Conclusion & recommendations: Leptin level was not affected by CKD stage & not a useful marker for growth in pediatric CKD patients. Large studies on relationship between leptin & growth are needed.

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