Association of Serum Adiponectin Levels with All-Cause Mortality in Hemodialysis Patients

Ohashi, Naro; Kato, Akihiko; Misaki, Taro; Sakakima, Masanori; Fujigaki, Yoshihide; Yamamoto, Tatsuo; Hishida, Akira

doi:10.2169/internalmedicine.47.0614

Cited by 58 publications

(43 citation statements)

References 26 publications

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“…7,45,64,83 Other studies support the hypothesis that high adiponectin predicts increased cardiovascular mortality in ESRD patients. [84][85][86] According to a recent study by Tung et al 47 specifically in PD patients during a 3.5-year follow-up, the results of the Kaplan-Meier survival analysis demonstrated fewer cardiovascular events and better survival in high adiponectin patients. On multivariate Cox regression analysis, only adiponectin level, age and history of cardiovascular diseases were independent risk factors for future cardiovascular events.…”

Section: Adiponectin and Cardiovascular Disease In Esrd Patientsmentioning

confidence: 99%

“…In support of this, adiponectin was not a significant predictor of mortality when wasted patients (serum albumin ≤35 g/l) were excluded in a study of HD patients. 84 Data in HD patients point to nonlinear associations between this adipokine and adverse clinical outcomes, implying that there may be lower and upper thresholds defining an optimal range of levels associated with improved outcomes.…”

Section: Adiponectin and Outcome In Esrdmentioning

confidence: 99%

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Adiponectin and end-stage renal disease

Markaki¹,

Psylinakis²,

Spyridaki³

2016

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Adiponectin (ADPN) is an adipokine with significant anti-inflammatory, insulin-sensitizing and anti-atherogenic properties, which is generally associated with a beneficial cardiometabolic profile. Paradoxically, end-stage renal disease (ESRD) is characterized by markedly increased plasma ADPN levels and increased cardiovascular risk. In spite of the cardioprotective properties attributed to adiponectin, cardiovascular complications remain the main cause of mortality in the ESRD population. Furthermore, these patients have enhanced chronic inflammation, increased insulin resistance and persistent protein-energy wasting. Studies of the impact of ADPN on clinical outcomes among ESRD patients have so far yielded contradictory results. This review article summarizes the current knowledge on ADPN functions and explores the role of ADPN in ESRD patients, with specific focus on inflammation, insulin resistance, cardiovascular disease and wasting.

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Section: Adiponectin and Cardiovascular Disease In Esrd Patientsmentioning

confidence: 99%

Section: Adiponectin and Outcome In Esrdmentioning

confidence: 99%

Adiponectin and end-stage renal disease

Markaki¹,

Psylinakis²,

Spyridaki³

2016

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“…However, data from studies investigating patients with renal disease do not follow consistently the high circulating adiponectin-low cardiovascular risk pattern. Specifically, regarding patients with renal disease, there are not only studies reporting that high serum adiponectin levels can predict decreased mortality and low future cardiovascular risk (Zoccali et al 2002, Becker et al 2005, Costacou et al 2005, Abdallah et al 2012), but there are also studies showing that high serum adiponectin levels are associated with increased mortality and incidence of CVD (Frystyk et al 2005, Menon et al 2006, Schalkwijk et al 2006, Jorsal et al 2008, Ohashi et al 2008). …”

Section: The Role Of Adiponectin In Diabetes-induced Albuminuriamentioning

confidence: 99%

The role of adiponectin in renal physiology and development of albuminuria

Christou¹,

Kiortsis²

2014

Journal of Endocrinology

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Adiponectin is secreted by the adipose tissue and is downregulated in states of obesity and insulin resistance. There is a growing body of evidence indicating that adiponectin has renoprotective effects and protects against the development of albuminuria in rodent experiments. Adiponectin crossing the glomerular filtration barrier possibly inhibits inflammation, fibrosis and oxidative stress in kidneys through activation of AMP-activated protein kinase. Moreover, microalbuminuria is a well established early sign of progressive cardiovascular and renal disease, even in subjects with preserved glomerular filtration rate. Studies investigating the relationship between serum adiponectin levels and urinary albumin excretion rate (UAE) have yielded conflicting data and the mechanisms underlying the interplay between adiponectin and albuminuria remain to be elucidated. This article constitutes a critical review attempting to clarify any remaining confusion about this matter. Furthermore, this article examines the clinical significance of adiponectin-albuminuria interplay, suggesting that adiponectin is possibly involved in the development of albuminuria that is associated with obesity, diabetes and cardiovascular disease and may mediate, at least in part, the actions of medical treatments that influence UAE, such as angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, thiazolidinediones, fenofibrate and diet. Further studies to investigate more thoroughly the renoprotective role of adiponectin in the human setting should be carefully planned, focusing on causality and the possible influence of adiponectin on the development of albuminuria in specific clinical settings.

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“…High levels of adiponectin in the general population are associated with fewer CV complications, such as coronary artery disease (3) and myocardial infarction (5). However, a high adiponectin level in patients undergoing hemodialysis (HD) is thought to be associated with a high CV mortality and/or all cause mortality (6,7). A recent cohort study showed that the level of adiponectin is associated with increased mortality in patients with chronic kidney disease (CKD) (8) and progressive decline of renal function (9).…”

Section: Introductionmentioning

confidence: 99%

Total and HMW Adiponectin is Independently Associated with B-type Natriuretic Peptide and Anemia in Chronic Hemodialysis Patients

Abe

Matsumae²,

Eto

et al. 2012

Intern. Med.

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Objective A number of vasculo-protective roles have been reported for adiponectin. In contrast, higher, rather than lower, plasma adiponectin levels are associated with an increased risk of cardiovascular disease and mortality in patients undergoing hemodialysis (HD). The mechanisms by which high adiponectin levels are associated with adverse outcome are unclear. Methods This study measured the level of total and high molecular weight (HMW) adiponectins in 70 patients with HD patients (age: 65.2±8.6 years, man/woman: 30/40), and examined the association between adiponectins, metabolic and echocardiographic parameters. Results Women had a significantly higher total, HMW levels and HMW to total ratio than men. The levels of total and HMW adiponectin were positively correlated with those of HDL-cholesterol and B-type natriuretic peptide (BNP) levels, and negatively associated with body mass index (BMI), triglyceride, high sensitive-C reactive protein (CRP) and hemoglobin levels. A multiple linear regression analysis showed that HMW adiponectin had an independent association with BMI (β=-0.270, p=0.003), HDL-cholesterol (β= 0.356, p<0.001), hemoglobin (β=-0.180, p=0.034) and BNP (β=0.200, p=0.014) as total did adiponectin. Conclusion Anemia and BNP levels had independent influence on the total and HMW adiponectin levels in chronic HD patients.

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Association of Serum Adiponectin Levels with All-Cause Mortality in Hemodialysis Patients

Abstract: Objective Adiponectin (ADPN)

Cited by 58 publications

References 26 publications

Adiponectin and end-stage renal disease

Adiponectin and end-stage renal disease

The role of adiponectin in renal physiology and development of albuminuria

Total and HMW Adiponectin is Independently Associated with B-type Natriuretic Peptide and Anemia in Chronic Hemodialysis Patients

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