Abstract
Patients with chronic kidney disease have abnormal energy expenditure and metabolism. The mechanisms underlying altered energy expenditure in uremia are unknown and remain to be elucidated. Irisin is a peroxisome proliferator-activated receptor γ coactivator 1-α–dependent myokine, and it increases energy expenditure in the absence of changes in food intake or activity. We hypothesize that chronic kidney disease patients have altered irisin levels. We measured resting irisin levels in 38 patients with stage 5 chronic kidney disease and in 19 age- and sex-matched normal subjects. Plasma irisin levels were significantly decreased in chronic kidney disease patients (58.59%; 95% CI 47.9%–69.2%, p<0.0001). The decrease in irisin levels was inversely correlated with the levels of blood urea nitrogen and creatinine. Further association analysis revealed that irisin level is independently associated with high-density lipoprotein cholesterol level. Our results suggest that chronic kidney disease patients have lower than normal irisin levels at rest. Furthermore, irisin may play a major role in affecting high-density lipoprotein cholesterol levels and abnormal energy expenditure in chronic kidney disease patients.
Highlights
Patients with chronic kidney disease (CKD) have altered energy expenditure.[1]
high-density lipoprotein (HDL) cholesterol was found to have a significant positive correlation with irisin (Table 3). These findings suggest that irisin levels are decreased in CKD patients and independently associated with HDL cholesterol levels
This study revealed that irisin levels are decreased in CKD patients without diabetes
Summary
Patients with chronic kidney disease (CKD) have altered energy expenditure.[1]. Epidemiological studies have demonstrated that the prevalence of metabolic imbalance and abnormal energy homeostasis in patients with CKD ranges from 20% to 80%.[2,3,4] Altered energy expenditure in CKD results in weight gain, obesity, protein-energy waste, and higher mortality.[5]. The kidneys account for approximately 7% of resting energy expenditure.[6] decreased renal blood flow and loss of renal function are associated with lower renal oxygen consumption and hypometabolic status.[7] Kidney failure results in multiple abnormalities in cellular metabolism, including impaired glucose metabolism, altered cellular protein turnover, metabolic acidosis, and inflammation.[8] an elevated inflammatory response, uncontrolled diabetes, and protein catabolism can contribute to increased energy expenditure. Lower physical activity, impaired skeletal muscle metabolism and insulin resistance can lead to decrease energy expenditure.[6,9,10]
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