Association Between Serum Leptin Level and Mortality in Kidney Transplant Recipients.
Leptin is a hormone made by adipocytes and associated with hypertension, inflammation, and coronary artery disease. Low serum leptin level was associated with higher risk of death in patients with advanced chronic kidney disease. Little is known about the association of serum leptin with outcomes in kidney transplant recipients.



Prospective prevalent cohort.



We collected sociodemographic and clinical parameters, medical and transplant history, and laboratory data of 979 prevalent kidney transplant recipients. Associations between serum leptin level and death with a functioning graft, all-cause death, and death-censored graft loss over a 6-year follow-up period were examined in survival models.



Serum leptin levels showed moderate negative correlation with eGFR (R = -0.21, P < .001) and positive correlations with BMI (R = 0.48, P < .001) and C-reactive protein (R = 0.20, P < .001). Each 10 ng/mL higher serum leptin level was associated with 7% lower risk of death with functioning graft (hazard ratio [HR] (95% confidence interval [CI]), 0.93 (0.87-0.99)), and this association persisted after adjustment for confounders: HR (95% CI), 0.90 (0.82-0.99). Similar associations were found with all-cause death as outcome. The association between serum leptin level and risk of graft loss was nonlinear, and only low serum leptin level was associated with higher risk of graft loss.



In prevalent kidney transplant recipients, lower serum leptin was an independent predictor of death.
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary. Electronic address: mzmolnar@uthsc.edu.
Miklos Z
MZ
Molnar
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Kristof
K
Nagy
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Adam
A
Remport
Department of Extracorporeal Hemocorrection, National Scientific Medical Research Center, Astana, Kazakhstan.
Abduzhappar
A
Gaipov
Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
Tibor
T
Fülöp
Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
Maria E
ME
Czira
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee.
Csaba P
CP
Kovesdy
Department of Medicine, Division of Nephrology and Multiorgan Transplant Program, University Health Network, University of Toronto, Toronto, Canada.
Istvan
I
Mucsi
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Zoltan
Z
Mathe
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000401:mortality; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality*; D016030:Kidney Transplantation / Q000009:adverse effects*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D020738:Leptin; D002097:C-Reactive Protein