New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is commonly associated with a high burden of comorbidities and poor clinical outcomes. Malnutrition–inflammation–atherosclerosis syndrome is common in the more severe stages of CKD, suggesting a close interplay for these three comorbid conditions. Both malnutrition and obesity are associated with a disturbed adipokine profile and inflammation, contributing to a higher risk of cardiovascular disease (CVD) events. Adiponectin and leptin have important roles in carbohydrate and lipid metabolism, and in the inflammatory process. The effects of adiponectin and leptin alterations in CKD, which are usually increased, and their association with the different comorbidities found in CKD, will be focused on to understand their crosstalk with the risk of CVD events. Nonetheless, although adiponectin and leptin contribute to a higher risk of CVD events, further studies are warranted to fully clarify their roles, especially when different comorbidities exist.

The Association between Serum Adiponectin Levels and Endothelial Function in Non-Dialysis-Dependent Chronic Kidney Disease Patients

“…The uremic milieu can disrupt adipocyte metabolism, leading to pathogenic consequences. In CKD populations, increased adiponectin production occurs in both visceral and subcutaneous adipose tissues, while circulating adiponectin levels in pre-dialysis CKD patients negatively correlate with eGFR [ 31 ]. Nevertheless, the impact of elevated adiponectin levels on CKD patients’ metabolism remains uncertain.…”

“…One plausible hypothesis for the association between high serum adiponectin concentrations and adverse CV outcomes in CKD patients is the development of adiponectin resistance, especially among those undergoing dialysis, owing to the uremic environment. An alternative explanation is that adiponectin secretion rises significantly to counterbalance the effects of heightened inflammatory cytokines and/or vascular injuries, but the inflammatory environments and proatherogenic uremic might overpower its effects [ 31 ]. Our study showed that as the CKD stage progressed, the serum adiponectin levels elevated and serum adiponectin levels are negatively associated with eGFR.…”

Lipid metabolism and renal function markers in obese adolescents

“…In our another publication (in the press) we connected this fact with significantly higher serum concentration of leptin in this group which correlated positively with cystatin C concentration. Hyperleptynemia has negative impact on kidney function [ 25 ] and may result in cystatin C concentration increase in the group I. Cystatin C is considered an earlier and more accurate marker of GFR than creatinine [ 26 ]. In our study no significant correlation between this marker of renal function and lipid parameters was observed.…”

Obesity-related hypertension and chronic kidney disease: from evaluation to management

“…Leptin stimulates endocapillary proliferation and mesangial collagen deposition in the glomerulus by stimulating TNF-beta, leading to glomerulosclerosis [ 65 , 66 ]. In CKD and ESRD, different adipokine profiles of elevated leptin and adiponectin levels are observed [ 67 ]. Furthermore, cachexia (lower BMI) in the setting of a uremic milieu has also been reported to elevate the adiponectin level.…”