Paper

Obesity in Chronic Kidney Disease: Good or Bad?
Jonas Axelsson

Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

Address of Corresponding Author

Blood Purif 2008;26:23-29 (DOI: 10.1159/000110559)

  Key Words

• Fat tissue
• Glucose intolerance
• Cardiovascular disease
• Chronic kidney disease

  Abstract

Cardiovascular disease (CVD) remains the major cause of morbidity and mortality in chronic kidney disease (CKD) patients. As traditional risk factors cannot alone explain the high prevalence and incidence of CVD in this high-risk population, the complex of insulin resistance, oxidative stress, and endothelial dysfunction has increasingly been studied as important non-traditional risk factors. Recent studies show that the adipose tissue is a complex organ with functions far beyond the mere storage of energy. Indeed, it has recently been shown that fat tissue secretes a number of adipokines - including leptin, adiponectin and retinol-binding protein, as well as cytokines such as resistin, visfatin, tumor necrosis factor and interleukin-6. Adipokine serum levels are furthermore markedly elevated in CKD, likely due to a decreased renal excretion. Evidence suggests that these pluripotent signaling molecules may have multiple effects modulating insulin signaling, endothelial health and putatively CVD. As fat tissue is also a storage depot for energy, much needed in the catabolic milieu of uremia, further research is still needed to elucidate the likely complex interactions between these signaling networks, vascular health and outcome in this high-risk population.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Jonas Axelsson, MD, PhD
Department of Clinical Science, Intervention and Technology
Karolinska Institutet
SE-14186 Stockholm (Sweden)
Tel. +46 858 583 981, Fax +46 858 583 925, E-Mail jonas.axelsson@ki.se

  Article Information

Published online: January 10, 2008
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 0, Number of References : 70