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Ghrelin and leptin pathophysiology in chronic kidney disease

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Abstract

Ghrelin is an orexigenic hormone with additional effects on the regulation of inflammation and the cardiovascular system. It may play an important role in the pathogenesis of cachexia/protein-energy wasting (PEW), inflammation and cardiovascular complications in chronic kidney disease (CKD). There are three circulating gene products of ghrelin, namely, acyl ghrelin, des-acyl ghrelin and obestatin, each with individual distinct functions. Perturbations of these circulating ghrelin proteins impact the overall milieu of CKD. Leptin is an anorexigenic hormone which is secreted from the adipocytes and interacts with ghrelin and other appetite-regulating hormones. Leptin also plays a role in regulating inflammation and the cardiovascular system. Indeed, ghrelin and leptin may play yin-and-yang roles in CKD pathophysiology. Clinical trials involving the use of the mimetics or antagonists of these hormones are limited to short-term phase I/II studies. Further understanding of their interactions in CKD pathophysiology is needed for potential large-scale clinical trials, which may impact the quality of life and survival of patients with CKD.

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Acknowledgments

Robert Mak is supported by the National Institute of Health U01 DK066143 grant and investigator-initiated grants from the Cystinosis Foundation and Abbott Inc.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, University of California San Diego–Rady Children’s Hospital, San Diego, CA, USA

    Sujana S. Gunta & Robert H. Mak

  2. Division of Pediatric Nephrology, University of California San Diego, La Jolla, CA, 92093-0634, USA

    Robert H. Mak

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  1. Sujana S. Gunta
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  2. Robert H. Mak
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Correspondence to Robert H. Mak.

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Gunta, S.S., Mak, R.H. Ghrelin and leptin pathophysiology in chronic kidney disease. Pediatr Nephrol 28, 611–616 (2013). https://doi.org/10.1007/s00467-012-2380-9

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  • DOI: https://doi.org/10.1007/s00467-012-2380-9

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