Hyperleptinaemia of end-stage renal disease is corrected by renal transplantation

Background: Previous studies have reported thatpatients with end-stage renal disease (ESRD) have elevated plasma leptinconcentrations, but the cause and significance of the elevations areunknown. We studied leptin concentrations in 29 adults undergoing renaltransplantation, to determine if restoration of renal function reducedleptin concentrations in ESRD. Methods: Leptinconcentrations were measured by radioimmunoassay in plasma specimenscollected within 1 week before transplant, 6 days post-transplant, and 60days post-transplant. Results: Plasma letpinconcentrations were higher in both male and female ESRD patients comparedwith a control population of similar age and body mass index (BMI), butmost of the disparity was due to a minority of patients with grosslyelevated concentrations; the majority of ESRD patients had normal ornear-normal leptin concentrations afer accounting for their adiposity withBMI. Six days after successful renal transplantation, average plasma leptinconcentrations decreased to control levels. The grossly elevatedpretransplant concentrations in a minority of patients were greatly reducedin relation to BMI, and the reduction persisted to 60 days post-transplant.The decrease in creatinine with transplant did not correlate with thedecrease in leptin. Conclusions: These resultsdemonstrate that restoration of renal function in ESRD patients reduceshyperleptinaemia, which provides further evidence of a cause/effectrelationship between impaired renal function and abnormal leptinmetabolism.