Department of Medical, Surgical and Health Sciences, Clinica Medica, University of Trieste, Italy.
J Ren Nutr. 2012 Jan;22(1):171-5. doi: 10.1053/j.jrn.2011.10.017.
Patients with chronic kidney disease (CKD) are prone to nutritional complications with negative prognostic impact. In particular, protein-energy wasting is a major CKD-associated clinical burden, and emerging evidence indicates that clustered metabolic alterations, including inflammation, oxidative stress, and insulin resistance, contribute to loss of skeletal muscle mass. Ghrelin is a gastric hormone discovered in its acylated form and extensively studied for its appetite-stimulating effect. Further studies have shown that ghrelin may positively modulate systemic inflammation and insulin action. In addition, a role of ghrelin in the regulation of redox state has been described in vitro. Ghrelin treatment could therefore represent a potential comprehensive therapeutic approach for CKD-related metabolic and nutritional complications, and evidence supporting this hypothesis has emerged in clinical and experimental CKD. Clinical trials of ghrelin administration are needed to test the hypothesis that ghrelin may chronically improve nutritional status and outcome in CKD patients.
患有慢性肾脏病（CKD）的患者易发生具有负面预后影响的营养并发症。特别是，蛋白质能量消耗是 CKD 相关的主要临床负担，新出现的证据表明，包括炎症、氧化应激和胰岛素抵抗在内的代谢异常簇集与骨骼肌质量损失有关。胃饥饿素是一种在酰化形式中发现的胃激素，其对食欲刺激作用的研究非常广泛。进一步的研究表明，胃饥饿素可能对全身炎症和胰岛素作用产生积极的调节作用。此外，在体外已经描述了胃饥饿素在氧化还原状态调节中的作用。因此，胃饥饿素治疗可能代表了一种针对 CKD 相关代谢和营养并发症的潜在综合治疗方法，并且在临床和实验性 CKD 中已经出现了支持这一假设的证据。需要进行胃饥饿素给药的临床试验来检验这样一个假设，即胃饥饿素可能会慢性改善 CKD 患者的营养状况和结局。
