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ADIPOKINES AND GUT HORMONES IN END-STAGE RENAL DISEASE

Division of Pediatric Nephrology,¹ Oregon Health and Science University, Portland, Oregon, and Division of Pediatric Nephrology,² University of California at San Diego, La Jolla, California, U.S.A.

Correspondence to: R.H. Mak, Division of Pediatric Nephrology, University of California at San Diego, 9500 Gilman Drive, MC 0831, La Jolla, California 92093-0831 U.S.A. romak{at}ucsd.edu

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor , interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

KEY WORDS: Inflammation; cachexia; end-stage renal disease; ESRD; adipokines; ghrelin; peptide YY; cholecystokinin.

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