Serum Leptin in Patients with Chronic Renal Failure on Different Modes of Management

摘要

Aim: To study serum leptin level in chronic renal failure (CRF) patients on different modes of management and to analyze the impact of the mode of therapy on serum leptin level. Subjects and Methods: This study was conducted on 64 patients (33males&31females) with chronic renal failure divided into three groups: group I: Twenty-six patients treated conservatively and did not start dialysis yet (predialysis), group II: Twenty-four patients treated by hemodialysis, group III: Fourteen patients treated by continuous ambulatory peritoneal dialysis (CAPD). Twenty healthy subjects were included as control group. All patients and controls were subjected to full clinical examination including height and weight to calculate body mass index (BMI). Blood urea and serum creatinine were measured as renal function tests. Serum leptin was measured by EASIA and so serum insulin. Results: In predialysis and CAPD groups, there is a significant increase in leptin , leptin/ BMI and insulin in patients in comparison to control subjects. In hemodialysis group, there is a significant increase in leptin and leptin/ BMI and a non-significant increase in insulin level in patients in comparison to control subjects. Insulin is significantly correlated with leptin in the first group, while in the second and third groups there is no correlation. The highest leptin level is found in the CAPD group of patients followed by the predialysis one then the hemodialysis group. Leptin level is significantly higher in females than males in all groups. This difference remained after adjusting leptin level to BMI. No correlation was found between leptin level and age or between leptin level and renal function in the three groups of patients. No correlation was found between leptin level and the duration of dialysis in the hemodialysis and CAPD groups. Conclusion: Serum leptin is elevated in CRF patients irrespective of the type of management they are undergoing. Dialysis, has no significant effect on leptin level. The two main predictors of serum leptin level are sex and BMI in CRF patients and in healthy subjects. Leptin level may serve as a valuable clinical marker for body adiposity