title: Low serum leptin predicts mortality in patients with chronic kidney disease stage 5.
abstract: OBJECTIVE
  Leptin, secreted from adipose tissue, regulates food intake, energy expenditure, and immune function. It is unknown whether leptin predicts mortality in patients with chronic kidney disease stage 5 on hemodialysis therapy.
  
  
  METHODS
  We performed a prospective cohort study of 71 patients with chronic kidney disease stage 5 in an outpatient hemodialysis center. Subjects were recruited in June 1998 and followed for 83 months. Survival was compared by the Kaplan-Meier method.
  
  
  RESULTS
  After 83 months of follow-up, 48 patients (68%) had died. Serum leptin concentrations at study entry were lower among all deceased patients compared with those patients who survived (5.2 +/- 9.0 microg/L; n = 48; vs. 7.7 +/- 7.8 microg/L; n = 23; p = 0.005). Baseline serum leptin concentrations were significantly lower in patients who died from cardiovascular diseases (4.7 +/- 9.4 microg/L, n = 32) or infections (4.0 +/- 2.7 microg/L; n = 10; each p < 0.05), but not cancer (9.4 +/- 7.9 microg/L; n = 6), than in survivors (7.7 +/- 7.8 microg/L; n = 23; p = 0.003). The relative risk for mortality in patients with serum leptin concentrations below the median (<2.6 microg/L) compared with patients above the median was 1.96 (95% confidence interval, 1.01 to 3.79; p = 0.04). Survival was shorter in patients with leptin concentrations below the median compared with those whose leptin concentrations were above the median (all-cause mortality, chi(2) = 5.05; p = 0.02).
  
  
  CONCLUSIONS
  Low serum leptin concentration is an independent predictor of mortality in patients with chronic kidney disease stage 5 on hemodialysis therapy.
authors.affiliation: Med. Klinik IV, Nephrologie, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Scholze
authors.forename: Dirk
authors.initials: D
authors.lastname: Rattensperger
authors.forename: Walter
authors.initials: W
authors.lastname: Zidek
authors.forename: Martin
authors.initials: M
authors.lastname: Tepel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D020738:Leptin