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International Journal of Hypertension
Volume 2012, Article ID 943605, 7 pages
http://dx.doi.org/10.1155/2012/943605
Review Article

Chronic Kidney Disease, Obesity, and Hypertension: The Role of Leptin and Adiponectin

1Division of Internal Medicine, Department of Medicine of the Systems, University of Rome “Tor Vergata”, Rome, Italy
2Division of Nephrology, Department of Medicine of the Systems, University of Rome “Tor Vergata”, Rome, Italy
3Division of Pharmacology, Department of Medicine of the Systems, University of Rome “Tor Vergata”, Rome, Italy
4Department of Internal Medicine, “Università Cattolica del Sacro Cuore”, Rome, Italy

Received 14 September 2012; Accepted 5 December 2012

Academic Editor: B. Waeber

Copyright © 2012 M. Tesauro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic kidney disease is a major public health problem and characterized by a progressive loss in renal function over a period of months or years as defined by structural or functional abnormalities of the kidney. Several elements contribute to determine a progression of the kidney injury, inducing a worsening of renal damage and accelerating the decline of renal function: obesity and hypertension are two known factors of kidney progression. Remarkable improvements have been recently achieved in the study of the endocrine features of the adipose tissue and have been able to produce hormone-like peptides named adipokines or adipocytokines. Among these adipocytokines, which represent a link between obesity, hypertension, and chronic nephropathy, leptins and adiponectin appear to play an important role. Leptin not only is a prohypertension element (renal progression factor) through the activation sympathetic nervous, but also is able to induce prosclerotic effects directly on the kidney. In contrast, a decline of adiponectin levels has been shown to be related to a picture of hypertension: an endothelial dysfunction has been described as the main pathogenic mechanism responsible for this phenomenon.