الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Resistin was discovered in 2001 by the group of Dr. Mitchell A. Lazar from the University of Pennsylvania School of Medicine. It was called ”resistin” because of the observed insulin resistance in mice injected with resistin. Resistin is a cysteine-rich, 108 – amino - acid peptide hormones with a molecular weight of 12.5 kDa that in humans is encoded by the RETN gene.
In rodents, resistin is expressed and secreted almost exclusively by adipocytes. In humans, on the other hand, resistin is highly expressed in monocytes and macrophages; thus, its pathophysiological role may differ between species.
Although resistin was first postulated to contribute to insulin resistance, it has recently been shown that resistin mRNA expression in human peripheral blood mononuclear cells is increased by proinflammatory cytokines.
CKD is characterized by an irreversible deterioration of renal function that gradually progresses to ESRD. CKD has emerged as a serious public health problem. Data from the united states renal data system (USRDS) shows that incidence of kidney failure in children has steadily increased.
Kidney is an important site of resistin clearance, because elevated resistin levels have been associated with decreased glomerular filtration rate.
The aim of our study is to evaluate the serum concentration of resistin in pediatric patient with chronic renal failure on conservative treatment and on haemodialysis.
This study was carried out on 30 children (19 males & 11 females) with chronic renal disease, their ages ranged from (4 to 19) years old (mean 11.5 years) .Age and sex matched 20 healthy children (12 males & 8 females) were included as the control group. Patients and control were categorized according to calculation of GFR by Modification of Diet in Renal Disease (MDRD).
Group I: Comprised 20 healthy children serving as control group. Age and sex were matched to patient groups (group II&III).They were12 males and 8 females; their ages range (4 - 19) years (mean 11.5 years).
Group II: Comprised 12 children with chronic renal failure on treatment. They were 9 males and 3 females; their ages range (4 – 19) years (mean 11.5 years).
Group III: Comprised 18 children with end stage renal disease on regular haemodialysis. They were 10 males and 8 females; their ages range (6 - 19) years (mean 12.5 years). Patients were undergoing haemodialysis three times per week, with each dialysis session lasting for three to four hours. Dialysis was started when GFR is equal or less than 15 ml/min./1.73m2.
Patients were referred from the nephrology and hemodialysis units of pediatric Department, Benha University Hospital and blood samples were collected and subjected to the following investigations (blood leukocytes, erythrocytes, hemoglobin, platelets, serum creatinine, serum albumin, sodium, potassium, GFR, highly sensitive CRP and serum resistin) which were done in Department of Medical Biochemistry, Faculty of medicine, Benha University.
Our results showed significant decrease (p<0.01) of blood erythrocytic count, hemoglobin concentration, platelets count, serum albumin, sodium and GFR in both patient groups (group II & group III) as compared to healthy control group (group I). Also, there were significant increase (p>0.001) of blood leukocytic count, serum creatinine, potassium, highly sensitive CRP in both patient groups (group II & group III) as compared to healthy control group (group I).
Serum level of resistin was significantly increased in both patient groups (18306.7 and 20171.5 ng/dl) as compared to healthy control group (6259.8 ng/dl). Also, there was an increase in serum resistin level in group III as compared to group II but not reached to statistical level.
There were significant positive correlations between resistin and leukocytic count &hs CRP in both patient groups (group II & group III). Also, there was a significant negative correlation between resistin and glomerular filtration rate in all studied groups (group I, group II & group III).