Background: Malnutrition and inflammation are associated with morbidity and mortality
in patients on maintenance hemodialysis (MHD). Ghrelin, an orexigenic peptide hormone,
is speculated to be associated with nutritional and inflammatory status in MHD. Aim: To
assess the serum total ghrelin levels and its possible relationship with inflammation and
nutritional status in patients on MHD. Subjects and Methods: The study was conducted on
90 patients on MHD for 6 months and above (56 males, 34 females, mean age 52.6 [11.7]
years; mean dialysis vintage 20.9 [12.1] months) and 70 healthy volunteers as control (5 males,
25 females, mean age 50.6 [9.7] years). Demographics were obtained for the study population,
and dialysis‑related data were collected for cases. Anthropometry, biochemical parameters,
serum total ghrelin and inflammatory markers tumor necrosis factor‑alpha (TNF‑α),
and high‑sensitivityC‑reactive protein (hsCRP) were assessed for cases and control.
Self‑reported appetite (five questions of appetite and diet assessment tool) and nutritional
status (subjective global assessment‑dialysis malnutrition score) were assessed for cases.
Results: Ghrelin (242.5 [62.3] pg/mL vs. 80.2 [19.6] pg/mL; P < 0.001), TNF‑α (39.8 [15.2]
pg/mL vs. 6.5 [1.2] pg/mL; P < 0.001), hsCRP (10.2 [2.8] mg/L vs. 2.7 [0.54] mg/L; P < 0.001)
were significantly elevated in cases versus control, anthropometry, and biochemical parameters
were significantly decreased in hemodialysis patient. Of 90 cases, (13/90 [14.4%]) were
well‑nourished, (28/90 [31%]) mild to moderately malnourished, and (49/90 [54.4%]) were
moderate to severely malnourished. Appetite was very good for14.4%, good and fair for 47.8%,
poor and very poor for 37.8% patients. There was a significant difference in appetite with
respect to nutritional status (P < 0.001). Ghrelin had positive correlation with inflammatory
markers and negative correlation with nutritional status (P < 0.001). Conclusion: The study
identified the association of ghrelin with appetite, nutritional, and inflammatory status of
the patients on MHD.