Introduction
Malnutrition is the major co-morbid condition of patients on dialysis, regular monitoring of nutritional status should be apart of treatment .Ghrelin is a stomach-derived hormone
 
Aim of the Study
The aim of this study is to investigate the changes in levels of serum ghrelin in end-stage renal disease patients receiving dialysis treatment and its relationship to some malnutrition markers.
 
Patients and Methods
This prospective case control study was conducted in the Nephrology Unit of our University Hospital, 46 patient were included in this study ; they were classified into two groups , cases group comprised 23 children with chronic 
renal failure on regular hemodialysis control group comprised 23 children matched for age and sex body mass idex , Malnutrition inflammation score, total protein, albumin, blood urea nitrogen, creatinine, total iron binding capacity, ferritin, and cholesterol., Serum ghrelin levels
 
Results
Ghrelin was significantly higher in cases than control mean 4769.0957 , Ghrelin sensitivity was 87.0 % , specificity was 78.3 % , positive predictive value was  80.0 % , negative predictive value was 85.7 % and accuracy was 82.6 % , cutoff value was >2070. Cases showed significant higher than control mean levels for ferritin, cholesterol and lower Hemoglobin, total iron binding capacity and total proteins. Cases showed significant high level of Ghrelin compared to normal control.
 
Conclusion
Ghrelin level increased in Hemodialysis patient, increased Ghrelin level might be related to anorexia . It could be used as a prognostic nutritional marker.