title: Leptin as an uremic toxin: Deleterious role of leptin in chronic kidney disease.
abstract: White adipose tissue secretes a large variety of compounds named adipokines amongst which, leptin exhibits pleiotropic metabolic actions. Leptin is an anorexigenic hormone, secreted in proportion of fat mass, with additional effects on the regulation of inflammation, cardiovascular system, immunity, hematopoiesis and bone metabolism. Chronic kidney disease (CKD) is characterized by an increase of plasma leptin concentration that may be explained by a lack of renal clearance. Hyperleptinemia plays a key role in the pathogenesis of complications associated with CKD such as cachexia, protein energy wasting, chronic inflammation, insulin resistance, cardiovascular damages and bone complications. Leptin is also involved in the progression of renal disease through its pro-fibrotic and pro-hypertensive actions. Most of the adverse effects of leptin have been documented both experimentally and clinically. Leptin may therefore be considered as an uremic toxin in CKD. The aim of this review is to summarize the pathophysiological and clinical role of leptin in in vitro studies, experimental models, as well as in patients suffering from CKD.
authors.affiliation: Université de Lyon, INSERM U1060, CarMeN, INSA de Lyon, Univ Lyon-1, F-69621 Villeurbanne, France; Hospices Civils de Lyon, Department of Nephrology, Hôpital E Herriot, Lyon F-69003, France. Electronic address: pascalinealix@hotmail.fr.
authors.forename: Pascaline M
authors.initials: PM
authors.lastname: Alix
authors.affiliation: Université de Lyon, INSERM U1060, CarMeN, INSA de Lyon, Univ Lyon-1, F-69621 Villeurbanne, France; Hospices Civils de Lyon, Department of Nephrology, Hôpital E Herriot, Lyon F-69003, France.
authors.forename: Fitsum
authors.initials: F
authors.lastname: Guebre-Egziabher
authors.affiliation: Université de Lyon, INSERM U1060, CarMeN, INSA de Lyon, Univ Lyon-1, F-69621 Villeurbanne, France.
authors.forename: Christophe O
authors.initials: CO
authors.lastname: Soulage
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D002100:Cachexia / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000378:metabolism / Q000473:pathology; D007249:Inflammation / Q000378:metabolism* / Q000473:pathology; D007333:Insulin Resistance; D020738:Leptin / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*; D054411:Receptors, Leptin / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000378:metabolism* / Q000473:pathology; D014118:Toxins, Biological / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*
chemical_list: D020738:Leptin; D054411:Receptors, Leptin; D014118:Toxins, Biological
keywords: Chronic kidney disease; Leptin; Protein-energy wasting; Renal fibrosis; Uremic toxin