Recently, the adipocytokines such as leptin, adiponectin and gut hormones such as ghrelin have also been potentially implicated in the pathogenesis of anorexia-cachexia and metabolic dysfunction (e.g. dyslipidemia) in ESRD [26], as have reported disturbances of normal growth hormone (GH) - insulin-like growth factor-1 (IGF-1) axis activities [27]. This evidence concerns the gene IGF1 and metabolic syndrome.