Title:Increased Risk of Cardiovascular Complications in Chronic Kidney Disease: A Possible Role of Leptin
Volume: 20
Issue: 4
Author(s): Agnieszka Korolczuk and Jaroslaw Dudka
Affiliation:
Keywords:
Leptin, cardiovascular disease, chronic kidney disease, obesity.
Abstract: Leptin is a small peptide hormone (16 kDa), a product of the obesity gene (Ob), and is mainly synthesized and secreted by
adipocytes. It is removed from the blood by the kidneys. The kidney is not only a site of leptin clearance, but also a target organ for its
action in different pathophysiological states. Several studies have documented a strong relationship between chronic kidney disease
(CKD) and accelerated cardiovascular disease (CVD) defined as a cardiorenal syndrome. Patients with stage 3 and 4 CKD develop cardiovascular
complications and are at increased risk of death from CVD. Renal dysfunction promotes several mechanisms responsible for
exacerbation of cardiovascular disease. These include activation of the renin-angiotensin system, oxidative stress, elevated asymmetric
dimethylarginine (ADMA), low-grade inflammation with increased circulating cytokines, and dyslipidemia. Recently, it has been observed
that plasma leptin level is elevated in patients with cardiorenal syndrome. In obesity, hyperleptinemia combined with selective
leptin resistance appear to have a critical role in the development and progression of kidney disease, CVD and metabolic syndrome. This
has clinical implications for the treatment of obesity–related hypertension and kidney disease. In this paper the role of leptin in chronic
kidney disease and accelerated cardiovascular disease is out lined. The link between hyperleptinemia and development and progression of
morphologic changes that effect kidney in obese patients is also discussed.
