SERUM LEPTIN LEVEL AND ITS RELATIONSHIP WITH CONVENTIONAL LABORATORY AND ANTHROPOMETRIC INDICES OF MALNUTRITION IN PATIENTS ON MAINTENANCE DIALYSIS.

Dr. Nahid Afrin*, Dr. Faruque Ahmed, Dr. G. M. Hafizur Rahman, Professor Dr. Muhammad Rafiqul Alam4, Dr. Hossain Muhammad Mustafijur Rahman, Dr. Tanvir Rahman, Dr. Al Asma Ul Taslima, Dr. Golam Mahabub Sikder and Dr. Rafi Nazrul Islam

ABSTRACT

Background: Nutrition is one of the key parameters in predicting morbidity and mortality in patients with end stage renal disease (ESRD) on dialysis. Body weight, BMI, visceral protein level (serum protein, albumin, and transferrin) has traditionally been used as markers for nutritional status. Serum leptin has been recently added to the list of markers of nutritional status. It has been reported that serum leptin levels are high in patients with ESRD patients. Objective: The purpose of the present study was to measure serum leptin level and to study the relationship between serum leptin concentration, anthropometric measurements and laboratory markers of malnutrition in patients diagnosed as end stage renal disease on maintenance dialysis (HD/ CAPD). Methods: This cross sectional study was conducted from April 2017 to March 2018 in the Department of Nephrology at Bangabandhu Sheikh Mujib Medical University, Dhaka. Adult patients with chronic kidney disease stage 5 on dialysis (HD and CAPD) for > 3 months were included. Modified SGA was used where score <10 is normal, >10 was taken as malnutrition. Skin fold thicknesses, body mass index (BMI) and mid arm muscle circumference (MAMC) were calculated for anthropometry. Laboratory parameter like hemoglobin, serum creatinine, albumin, leptin, lipid profile, iron profile was done. Result: Serum leptin level of CAPD patients was higher when compared with those of HD patients. Serum leptin level significantly correlated positively with duration of dialysis, and serum creatinine in both groups and with age, BMI only in HD group. Conclusion: Based on above observations, we conclude that serum leptin level correlates with several malnutrition markers such as BMI, duration of dialysis, serum creatinine, serum iron.

Keywords: Serum leptin, Anthropometry, Malnutrition, End stage renal disease (ESRD), Maintenance dialysis (HD/ CAPD).