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CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Role of Leptin in Reverse Epidemiology in Chronic Kidney Disease
Author(s) -
Scholze Alexandra,
Tepel Martin
Publication year - 2007
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2007.00334.x
Subject(s) - leptin , medicine , adipose tissue , endocrinology , kidney disease , hemodialysis , biomarker , dialysis , appetite , obesity , disease , kidney , risk factor , chemistry , biochemistry
Leptin is mainly produced by adipocytes and metabolized in the kidney. Leptin is taken up into the central nervous system by a saturable transport system, and controls appetite in rodents and in healthy subjects. Leptin acts on peripheral tissue and increases the inflammatory response by stimulating the production of tumor necrosis factor alpha, interleukin‐6 and interleukin‐12. In healthy humans, serum leptin concentration is related to the size of adipose tissue mass in the body. The majority of obese subjects have inappropriately high levels of circulating plasma leptin concentrations, indicating leptin resistance. In healthy subjects increased leptin concentration constitutes a biomarker for increased cardiovascular risk. On the other hand, a recent prospective long‐term study in patients with chronic kidney disease stage 5 on hemodialysis therapy showed that reduced serum leptin concentration is an independent risk factor for mortality in these patients.