Adiponectin in Chronic Kidney Disease

Abstract

Adiponectin is the adipokine associated with insulin sensitization, reducing liver gluconeogenesis, and increasing fatty acid oxidation and glucose uptake. Adiponectin is present in the kidneys, mainly in the arterial endothelium and smooth muscle cells, as well as in the capillary endothelium, and might be considered as a marker of many negative factors in chronic kidney disease. The last few years have brought a rising body of evidence that adiponectin is a multipotential protein with anti-inflammatory, metabolic, anti-atherogenic, and reactive oxygen species (ROS) protective actions. Similarly, adiponectin has shown many positive and direct actions in kidney diseases, and among many kidney cells. Data from large cross-sectional and cohort studies showed a positive correlation between serum adiponectin and mortality in chronic kidney disease. This suggests a complex interaction between local adiponectin action, comorbidities, and uremic milieu. In this review we discuss the role of adiponectin in chronic kidney disease.

Association of serum adiponectin and leptin levels with renal function in kidney transplant recipients with or without new‐onset diabetes after transplantation

“… 15 Adiponectin has traditionally been associated with insulin sensitization, reducing liver gluconeogenesis, and increasing fatty acid oxidation and glucose uptake. 19 We found an inverse correlation between circulating adiponectin levels and BMI in NODAT and non‐NODAT patients, p < 0.05 (Table 3 ). However, we only saw a significant negative correlation between plasma adiponectin and CRP levels in the group of patients after kidney transplantation, but not in the NODAT or non‐NODAT group alone (Table 3 ).…”

“…The liver primarily excretes adiponectin; however, only monomers and dimers may cross the glomerular filtration barrier and be found in urine due to the high molecular weight of the adiponectin monomer (28 kDa). 18 , 19 Many previous studies have reported elevated serum adiponectin concentrations in patients with chronic kidney disease. 20 , 21 , 22 Some main mechanisms can decrease renal adiponectin clearance 23 or respond to metabolic disorders in renal dysfunction.…”

“…Despite a negative metabolic status, patients with end‐stage renal disease have two to three times higher serum adiponectin levels than subjects with normal kidney function. 19 Adamczak et al 37 pointed out that factors contributing to lower adiponectin secretion are oxidative stress and sympathetic nervous activity, common in chronic kidney disease. Adiponectin is considered a marker of kidney injury and risk of disease progression, and it was a multipotential protein with anti‐inflammatory, metabolic, anti‐atherogenic, and reactive oxygen species protective actions.…”

Update on the Crosstalk Between Adipose Tissue and Mineral Balance in General Population and Chronic Kidney Disease

“…CKD is associated with perturbated adipokine profile. Reduced renal clearance of leptin and adiponectin, although the latter is primarily excreted by the liver, may in part explicate the higher serum leptin and adiponectin levels commonly observed in both adult and pediatric patients, compared to healthy controls (15)(16)(17)(18)(19)(20)(21)(22)(23). Moreover, body fat mass plays, as expected, a major role on adipokines expression among CKD patients (24,25).…”

“…In detail, relatively higher serum leptin (15,24,25) and relatively lower serum adiponectin levels (26) are often encountered in overweight adult and pediatric patients, while poor nutritional status is often related to lower leptin and higher adiponectin serum profile (27,28). Furthermore, uremic condition may affect adipokines production (20,29). Experimental studies indicated that uremic milieu increased adipocyte production of adiponectin and leptin (30)(31)(32).…”