Elevated baseline adiponectin level predicting an increased risk of disease activity in idiopathic nephrotic syndrome and chronic kidney disease in children.

BACKGROUND: Adiponectin, an adipocyte-derived protein, is present abundantly in circulation and has anti-atherogenic and anti-inflammatory effects, so we aimed to assess the role of adiponectin in idiopathic nephrotic syndrome and chronic kidney disease in children.

METHODS: Overall of 290 children, 95 patients with the steroid-responsive idiopathic nephrotic syndrome (50 in remission and 45 in relapse).Another 95 patients with chronic kidney disease (50 on hemodialysis and 45 on conservative therapies) and 100 apparently healthy matched children were enrolled into the study. Serum adiponectin levels, blood chemistry (protein/albumin, serum creatinine, blood urea and electrolytes levels) and 24-hour proteinuria w studied as well.

RESULTS: There was highly significant increasing differences in adiponectin level between the relapsed idiopathic nephrotic syndrome (26.93± 6.79 μg/mL) compared to remission (10.96± 3.33 μg/mL) and control group (4.89± 1.01 μg/mL) and between remission in comparing to control group (P <0.001). Also there was significant negative correlation between adiponectin level and serum albumin level in the relapse group (r=- 0.60, P=<0.05), and highly positive correlation between adiponectin level and 24-hour proteinuria in relapse (r=0.98, p= <0.001) and remission group (r= 0.92, P = <0.001). Regarding children with chronic kidney disease, There were high significant increasing differences in adiponectin levels in conservative (13.88 ± 4.27 μg/mL) and dialysis (15.09 ± 6.14 μg/mL) groups compared to controls (6.05 ± 5.83 μg/mL) with P <0.001. Furthermore, there was a significant positive correlation between adiponectin and serum creatinine &blood urea levels in both conservative and dialysis groups with P <0.05.

CONCLUSIONS: Adiponectin can be considered as an important useful biomarker for chronic kidney diseases in children.