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Adiponectin in children with chronic kidney disease: role of adiposity and kidney dysfunction

Mark Mitsnefes1, Janis Kartal, Philip Khoury

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229-3039, USA. mark.mitsnefes@cchmc.org

Clinical Journal of the American Society of Nephrology : CJASN
|August 21, 2007
PubMed

Insights

Serum adiponectin is elevated in children with chronic kidney disease (CKD). Decreased kidney function is a key factor, but overweight children have lower levels, potentially increasing cardiovascular risk.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Risk Factors
  • Endocrinology

Background:

  • Low serum adiponectin is a known cardiovascular risk in adults with chronic kidney disease (CKD).
  • Adiponectin levels and their association with cardiovascular risks in pediatric preterminal CKD remain understudied.
  • This study investigates adiponectin in children and adolescents with stages 2-4 CKD.

Purpose of the Study:

  • To determine serum adiponectin concentrations in children and adolescents with preterminal CKD.
  • To examine the relationship between adiponectin levels and cardiovascular risk factors in this population.
  • To identify predictors of serum adiponectin levels in pediatric CKD.

Main Methods:

  • Cross-sectional study of 44 children and adolescents (6-21 years) with stages 2-4 CKD.
  • Measurements included serum adiponectin, lipoproteins, inflammation markers, homocysteine, and insulin.
  • Patients were categorized as lean (BMI <85th percentile) or nonlean (BMI ≥85th percentile).

Main Results:

  • 83% of patients exhibited elevated serum adiponectin levels.
  • Lean patients had significantly higher adiponectin than nonlean patients (34.1 vs. 23.6 µg/ml, P=0.02).
  • Serum adiponectin negatively correlated with age, BMI, leptin, GFR, and insulin. GFR, BMI, and age independently predicted adiponectin levels.

Conclusions:

  • Serum adiponectin is elevated in pediatric CKD (stages 2-4), with decreased kidney function being a primary determinant.
  • Despite overall elevated levels, overweight pediatric CKD patients show lower adiponectin, suggesting potential future cardiovascular risk.
  • Further research is needed to understand the implications of these findings for cardiovascular health in young CKD patients.

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