0514. Adiponectin and renal disease

Several summaries during 2004 dealt with mediators released by adipose tissue and highlighted adiponectin's actions. This peptide is the most abundant of the adipocyte-derived cytokines and hormones, and displays insulin-sensitising, anti-inflammatory and anti-atherogenic properties. Several studies have drawn attention to adiponectin's relationship to clinical and biochemical parameters, and researchers see an important counter-regulatory mechanism in some disease states and an impaired one in others. High levels observed in essential hypertensives might be directed towards reducing endothelial damage and cardiovascular risk associated with high arterial pressure. On the other hand, reduced synthesis and low concentrations may be associated with endothelial dysfunction and cardiovascular diseases. Adiponectin is also substantially increased in patients with advanced renal failure and even more so in patients with nephrotic syndrome. Adiponectin levels correlate strongly and directly with 24-hour proteinuria and with serum cholesterol, while albumin correlates inversely. The latter relationships also suggest that this adipocyte-derived protein may mitigate endothelial damage triggered by dyslipidemia and other risk factors in patients with renal disease. In a recent study involving children with steroid-responsive nephrotic syndrome, adiponectin levels were extremely high in patients who had relapsed vs those in remission and vs controls.

Read more:
Pediatr Nephrol 2005;20:474-7
Kidney Int 2003;84 (May Suppl):S98-102
J Am Soc Nephrol 2002;13:134-41