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, 12 (3), 420-426

Obesity and Chronic Kidney Disease Progression-The Role of a New Adipocytokine: C1q/tumour Necrosis Factor-Related protein-1


Obesity and Chronic Kidney Disease Progression-The Role of a New Adipocytokine: C1q/tumour Necrosis Factor-Related protein-1

Diego Barbieri et al. Clin Kidney J.


Background: Obesity is a risk factor for incident chronic kidney disease (CKD) in the general population. C1q/tumour necrosis factor-related protein 1 (CTRP1) is a new adipokine with multiple vascular and metabolic effects and may modulate the association between obesity and vascular diseases. The aim of the study is to explore potential links between obesity, CTRP1 levels and CKD progression.

Methods: Patients with Stages 3 and 4 CKD without previous cardiovascular events were enrolled and divided into two groups according to body mass index (BMI). Demographic, clinical and analytical data and CTRP1 levels were collected at baseline. During follow-up, renal events [defined as dialysis initiation, serum creatinine doubling or a 50% decrease in estimated glomerular filtration rate (Modification of Diet in Renal Disease)] were registered.

Results: A total of 71 patients with CKD were divided into two groups: 25 obese (BMI >30 kg/m2) and 46 non-obese. CTRP1 in plasma at baseline was higher in obese patients [median (interquartile range) 360 (148) versus 288 (188) ng/mL, P = 0.041]. No significant association was found between CTRP1 levels and CKD stage, presence of diabetes, aldosterone and renin levels, or blood pressure. Obese patients had higher systolic blood pressure (P = 0.018) and higher high-sensitivity C-reactive protein (P = 0.019) and uric acid (P = 0.003) levels, without significant differences in the percentage of diabetic patients or albuminuria. During a mean follow-up of 65 months, 14 patients had a renal event. Patients with CTRP1 in the lowest tertile had more renal events, both in the overall sample (log rank: 5.810, P = 0.016) and among obese patients (log rank: 5.405, P = 0.020). Higher CTRP1 levels were associated with slower renal progression (hazard ratio 0.992, 95% confidence interval 0.986-0.998; P = 0.001) in a model adjusted for obesity, aspirin, albuminuria and renal function.

Conclusions: CTRP1 levels are higher in obese than in non-obese patients with CKD. High CTRP1 levels may have a renal protective role since they were associated with slower kidney disease progression. Interventional studies are needed to explore this hypothesis.

Keywords: CTRP1; adipokine; chronic kidney disease; obesity; progression.


Renal outcomes according to CTRP1 tertiles in the global sample (A) and in obese patients (B). More renal events occurred at the lowest CTRP1 tertile in the global sample [log rank: 5.810, P = 0.016 (A)] and in obese patients [log rank: 5.405, P = 0.020 (B)].

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    1. Mahmoodnia L, Tamadon MR. On the occasion of world kidney day 2017; obesity and its relationship with chronic kidney disease. J Nephropathol 2017; 6: 105–109 - PMC - PubMed
    1. Lu JL, Molnar MZ, Naseer A. et al. Association of age and BMI with kidney function and mortality: a cohort study. Lancet Diabetes Endocrinol 2015; 3: 704–714 - PMC - PubMed
    1. Lu JL, Kalantar-Zadeh K, Ma JZ. et al. Association of body mass index with outcomes in patients with CKD. J Am Soc Nephrol 2014; 25: 2088–2096 - PMC - PubMed
    1. Stenvinkel P, Zoccali C, Ikizler TA. Obesity in CKD—what should nephrologists know? J Am Soc Nephrol 2013; 24: 1727–1736 - PMC - PubMed
    1. Stengel B, Tarver-Carr ME, Powe NR. et al. Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology 2003; 14: 479–487 - PubMed