SP375
ASSOCIATION OF LEPTIN LEVEL AND ERYTHROPOIESIS-STIMULATING AGENTS HYPORESPONSIVNESS IN CHRONIC HEMODIALYSIS PATIENTS

INTRODUCTION: Leptin is a 16 kDa protein hormone, mainly secreted by adipocytes, upregulated by the obesity (ob) gene, and cleared by the kidneys. It has been reported that leptin is associated with the development of anorexia and malnutrition in uremic patients. Malnutrition and inflammation in hemodialysis patients lead to refractory anemia including unresponsiveness to erythropoiesis-stimulating agents (ESA). Recently, studies have been suggesting the role of leptin in early stage of erythropoiesis, and leptin has been found to stimulate hematopoietic stem cells in vitro. The aim of the study was to evaluate serum leptin levels and its associations withthe response to ESA in hemodialysis patients.

METHODS: We analyzed the erythropoietin resistance index (ERI), parameters of anemia, nutrition and inflammation status. The cross-section study included 83 subjects (mean patient age 64.3 ± 13.2 years), who were distributed in three groups according to leptin level: below (n=9), within (n=36) and above (n=38) reference range.

RESULTS: Low leptin level was associated with a higher ERI (8.84 ± 6.67 vs. 5.70 ± 4.43 vs. 3.84 ± 5.29, p<0,05). These patiens had a worse nutritional status (albumin 38.72±7.91 vs. 42.97±3.85 vs. 42.37±2.87, p<0,05; BMI 20.08±2.71 vs. 22.47±2.66 vs. 27.11±4.16, p< 0,001; total cholesterol 4.06±1.46 vs. 4.48±1.30 vs. 5.03±1.19, p<0,05) and higher inflammatory parameters (CRP: 13.28±16.71 vs. 7.69±11.35 vs. 9.64±10.8, p<0,001; ferritin: 818.33±628.88 vs. 448.92±297.49 vs. 461.82±323.13, p<0,001). A statistically significant inverse correlation was found between leptin level and ERI (r= -0.349, p<0,05). No significant correlation was found between leptin and hemoglobin, ferritin and CRP level.

CONCLUSIONS: In this study, leptin level affects the response to ESA in chronic hemodialysis patients.