THE AIM OF THE STUDY. To clarify the role of acyl-ghrelin in the development of protein-energy wasting of haemodialysis patients (HD). PATIENTS AND METHODS. A total of 645 patients receiving treatment with programmatic bicarbonate HD for 8.4 ± 5.3 years, including 345 women and 300 men, the average age was 56.8 ± 12.8 years. Nutritional status was assessed using the method proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). For the quantitative determination of acyl-ghrelin, the enzyme-linked immunosorbent assay kit “Active Ghrelin ELISA Kit” (highly sensitive method) from Sceti KK, Japan was used in this work. Reference values: 30-62 fmol/ml. RESULTS. The prevalence of protein-energy wasting (PEM) using the ISRNM method was 24.9% (160 patients). Reduced levels of acyl-ghrelin were detected in 352 patients (54.5%). The average acyl-ghrelin values in patients without signs of PEW were 50.2±10.3 fmol/ml, and in patients with PEW 24.9±9.2 fmol/ml (p