Leptin elimination in hyperleptinaemic peritoneal dialysis patients

Michael Landt, Curtis A. Parvin, Samuel Dagogo-Jack, Barbara Bryant, Daniel W. Coyne

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background. Elevated plasma concentrations of leptin, a hormone thought to regulate body composition by influencing food intake/metabolic rate, are prevalent in renal failure patients. The mechanism for these increases is not known, but evidence suggests that simple accumulation due to decreased elimination is insufficient explanation. Methods. We studied the incidence of hyperleptinaemia in 28 end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis (CAPD), compared with body-mass-index-and sex-matched controls. Results were separated by gender because women have higher leptin concentrations than men. Excretion of leptin and other substances in dialysis fluid was also studied. Results. Hyperleptinaemia was prevalent in women CAPD subjects, but not in men. Plasma leptin concentrations correlated strongly with the daily excretion of leptin in dialysis fluid. Clearance of leptin in dialysis fluid was greater in men than women CAPD subjects. Single regression analysis found that fasting insulin, glucose content of dialysis fluid, plasma albumin, C-reactive protein, erythropoietin dose, urinary creatinine clearance and plasma β2-microglobulin were not determinants of plasma leptin concentrations. Stepwise forward multiple regression, examining the dependence of plasma leptin on body mass index, renal creatinine clearance, plasma albumin, daily dialysis fluid glucose load, daily leptin in dialysis fluid, erythropoietin dose and plasma C-reactive protein found only erythropoietin dose as a consistent negative predictor of plasma leptin concentrations. Conclusions. The results suggest that hyperleptinaemia of CAPD was due to predisposing loss of renal elimination capacity combined with increased production due to obesity (more prevalent in women subjects of this study) and potentially female gender.

Original languageEnglish (US)
Pages (from-to)732-737
Number of pages6
JournalNephrology Dialysis Transplantation
Volume14
Issue number3
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

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Peritoneal Dialysis
Leptin
Dialysis
Continuous Ambulatory Peritoneal Dialysis
Erythropoietin
Serum Albumin
C-Reactive Protein
Creatinine
Body Mass Index
Glucose
Body Composition
Chronic Kidney Failure
Renal Insufficiency
Blood Proteins
Fasting
Obesity
Eating
Regression Analysis
Hormones
Insulin

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Leptin elimination in hyperleptinaemic peritoneal dialysis patients. / Landt, Michael; Parvin, Curtis A.; Dagogo-Jack, Samuel; Bryant, Barbara; Coyne, Daniel W.

In: Nephrology Dialysis Transplantation, Vol. 14, No. 3, 01.01.1999, p. 732-737.

Research output: Contribution to journalArticle

Landt, Michael ; Parvin, Curtis A. ; Dagogo-Jack, Samuel ; Bryant, Barbara ; Coyne, Daniel W. / Leptin elimination in hyperleptinaemic peritoneal dialysis patients. In: Nephrology Dialysis Transplantation. 1999 ; Vol. 14, No. 3. pp. 732-737.
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