Significance of circulating adipocytokines in hypertensive patients with chronic kidney disease

Abstract

Introduction. Hypertension (HTN) is both a cause and effect of chronic kidney disease (CKD) and contributes to its progression. Visfatin and resistin, two of the key cytokines secreted by adipocytes, have been shown to be associated with HTN. The objective of our study was to investigate the association of plasma visfatin and resistin in HTN patients with CKD, after adjusting for multiple important risk factors of CKD. Materials and Methods. We investigated the association of plasma visfatin and resistin in 55 patients with HTN and CKD and in 55 HTN controls without CKD. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 or presence of albuminuria. Quantile regression and logistic regression models were used to examine the association between adipokines and CKD, adjusting for multiple confounding factors. Results. Compared to HTN patients without CKD, adjusted median visfatin value (48.0 vs. 22.1 ng/mL, p<0.0001) and adjusted mean resistin value (17.3 vs 9.8 ng/mL, p<0.0001) were significantly higher in HTN patients with CKD. The multiple-adjusted odds ratio (95% confidence interval) of CKD, comparing the highest tertile to the lower two tertiles, was 2.3. (1.1, 4.9) for visfatin and 13.8 (7.4, 25.2) for resistin. In addition, higher visfatin and resistin were independently associated with lower eGFR and higher urinary albumin levels. Conclusions. These findings suggest that adipocytokines are independently and significantly associated with the risk and severity of CKD in HTN patients. Longitudinal studies are warranted to evaluate the prospective relationship of adipocytokines to the development and progression of CKD.

Keywords

• chronic kidney disease
• hypertension
• adypocytokines
• visfatin
• resistin