Adipokines as predictive factor of cardiac function in pediatric patients with chronic kidney disease

Area of Science:

• Pediatric Nephrology
• Cardiology
• Endocrinology

Background:

• Adipokines, signaling proteins from adipose tissue, are implicated in cardiovascular disease (CVD).
• In pediatric chronic kidney disease (CKD), adipokine levels may offer prognostic insights for cardiovascular health.
• Understanding adipokine roles is crucial for managing CVD risk in children with CKD.

Purpose of the Study:

• To investigate the long-term association between leptin and adiponectin levels and cardiac function in children undergoing kidney replacement therapy (KRT).
• To determine if specific adipokines predict changes in cardiac function over a two-year period in pediatric KRT patients.

Main Methods:

• A prospective cohort study involving 56 pediatric patients (aged 8-17) on hemodialysis or peritoneal dialysis.
• Baseline assessments included lipid profiles, adipokines (leptin, leptin receptor, free leptin, adiponectin), anthropometrics, and cardiological evaluation.
• Cardiac function, specifically left ventricular ejection fraction (LVEF), was reassessed after 24 months.

Main Results:

• At baseline, 17.8% of patients had altered LVEF. Over 24 months, LVEF showed a median change of 3%.
• A positive correlation was observed between baseline free leptin levels and the change in LVEF (delta-LVEF).
• Multivariate analysis revealed that free leptin, leptin, and baseline LVEF were significantly associated with changes in LVEF at 24 months.

Conclusions:

• Baseline levels of free leptin and leptin are associated with a decrease in LVEF over 24 months in pediatric KRT patients.
• These adipokines, along with baseline LVEF, may serve as important indicators for long-term cardiac function monitoring in this vulnerable population.
• Further research is warranted to explore therapeutic strategies targeting adipokines to improve cardiac outcomes in children with CKD.