Increased Risk of Cardiovascular Complications in Chronic Kidney Disease: A Possible Role of Leptin

医学 心肾综合症 血脂异常 内科学 瘦素 肾脏疾病 透析 肥胖 内分泌学 疾病 代谢综合征
作者
Agnieszka Korolczuk,Jarosław Dudka
出处
期刊:Current Pharmaceutical Design [Bentham Science]
卷期号:20 (4): 666-674 被引量:10
标识
DOI:10.2174/13816128113199990013
摘要

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. Keywords: Leptin, cardiovascular disease, chronic kidney disease, obesity.
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