Medicine and BiotechnologyMedicine and BiotechnologyМедицина и биотехнологии3034-62313034-6258National Research Mordovia State University30097810.15507/3034-6231.001.202503.269-285jmqtpgInternal medicineВнутренние болезниReview ArticleKidney Involvement in Spondyloarthritis: A Literature ReviewПоражение почек при спондилоартритах: обзор литературыhttps://orcid.org/0009-0007-4051-665XKochurovEvgeny K.КочуровЕвгений Константинович
Russian Federation

Post-graduate student, Hospital Therapy Department with courses of Cardiology and Functional Diagnosis, Faculty of Advanced Training and Professional Retraining

аспирант кафедры госпитальной терапии с курсами кардиологии и функциональной диагностики факультета повышения квалификации и профессиональной переподготовки

evg.konst@yahoo.comhttps://orcid.org/0000-0002-3920-8234GaisinIlshat R.ГайсинИльшат Равилевич
Russian Federation

Doctor of Medical Sciences, Associate Professor of the Hospital Therapy Department with courses of Cardiology and Functional Diagnosis, Faculty of Advanced Training and Professional Retraining

Доктор медицинских наук, доцент, профессор кафедры госпитальной терапии с курсами кардиологии и функциональной диагностики факультета повышения квалификации и профессиональной переподготовки

igaisin@mail.ruhttps://orcid.org/0009-0004-0514-3040VedekhinaAnastasia N.ВедёхинаАнастасия Николаевна
Russian Federation

Deputy Assistant Professor of the Hospital Therapy Department with courses of Cardiology and Functional Diagnosis, Faculty of Advanced Training and Professional Retraining

и. о. ассистента кафедры госпитальной терапии с курсами кардиологии и функциональной диагностики факультета повышения квалификации и профессиональной переподготовки

anvedekhina@gmail.comIzhevsk State Medical AcademyИжевская государственная медицинская академия22092025132692851307202512092025Copyright ©; 2025, Kochurov E.K., Gaisin I.R., Vedekhina A.N.Copyright ©; 2025, Кочуров Е.К., Гайсин И.Р., Ведёхина А.Н.2025Kochurov E.K., Gaisin I.R., Vedekhina A.N.Кочуров Е.К., Гайсин И.Р., Ведёхина А.Н.https://creativecommons.org/licenses/by/4.0https://medbiosci.ru/MedBiotech/article/view/300978

Introduction. Currently, the identification and prevention of renal dysfunction in patients with spondyloarthritis receive insufficient attention, although kidney involvement can significantly determine their prognosis. The aim of this review is to analyze the types, prevalence, and risk factors for the development and progression of renal impairment in spondyloarthritis.

Materials and methods. A search for publications was conducted in the PubMed database using keywords for the period 2000–2024. Preference was given to original research, systematic reviews, and meta-analyses. Particular attention was paid to studies including kidney biopsy data, as well as works devoted to long-term patient follow-up. In addition, reference lists of review articles were examined to identify relevant publications. Ultimately, 66 studies were included in the review.

Results. Kidney involvement is a frequent complication of spondyloarthritis. The most common manifestations are AA amyloidosis, immunoglobulin A nephropathy, and chronic interstitial nephritis. Furthermore, patients are characterized by a significant prevalence and a greater risk of developing chronic kidney disease. High disease activity and duration, the presence of extra-articular manifestations, patient sex and age, time of diagnosis, the presence of human leukocyte antigen B27, and the levels of C-reactive protein, uric acid, immunoglobulins A and G, and albumin may indicate a high risk of kidney involvement.

The use of non-steroidal anti-inflammatory drugs, certain synthetic and biological disease-modifying antirheumatic drugs may be associated with the development of kidney diseases, particularly in the presence of risk factors such as pre-existing renal dysfunction and hypertension. Metabolic disorders have a significant impact on the development and progression of renal dysfunction. Kidney dysfunction, in turn, affects adipose tissue function and the progression of metabolic disorders.

Discussion and conclusion. Routine examination of patients with spondyloarthritis is necessary to detect kidney involvement, as well as to identify and correct factors contributing to the development and progression of renal dysfunction in this patient group.

Введение. В настоящее время выявлению и профилактике почечной дисфункции у пациентов со спондилоартритами уделяется недостаточное внимание, хотя поражение почек во многом может определить их прогноз. Цель обзора – проанализировать виды, распространенность, факторы риска развития и прогрессирования поражения почек при спондилоартритах.

Материалы и методы. Проведен поиск публикаций в базе данных PubMed по ключевым словам за 2000–2024 годы. Предпочтение отдавалось оригинальным исследованиям, систематическим обзорам и метаанализам. Особое внимание уделено исследованиям, включающим данные о биопсии почек, а также работам, посвященным длительному наблюдению за пациентами. Кроме того, для поиска актуальных публикаций были изучены списки литературы обзорных статей. В конечном итоге в обзор включены 66 исследований.

Результаты исследования. Поражение почек является частым осложнением спондилоартритов. Наиболее распространенными являются АA-амилоидоз, иммуноглобулин А-нефропатия и хронический интерстициальный нефрит. Кроме того, для больных характерна значительная распространенность и больший риск развития хронической болезни почек. Высокая активность и длительность заболевания, наличие внесуставных проявлений, пол и возраст пациентов, время постановки диагноза, наличие человеческого лейкоцитарного антигена B27, уровень С-реактивного белка, мочевой кислоты, иммуноглобулинов A и G и альбумина могут указывать на высокий риск развития поражения почек. Применение нестероидных противовоспалительных средств, некоторых синтетических и биологических болезнь-модифицирующих антиревматических препаратов может быть ассоциировано с развитием заболеваний почек, особенно при наличии факторов риска: предшествующей почечной дисфункции и гипертензии. Значительное влияние на развитие и прогрессирование почечной дисфункции оказывают метаболические нарушения. Дисфункция почек, в свою очередь, влияет на функцию жировой ткани и прогрессирование метаболических нарушений.

Обсуждение и заключение. Необходимы рутинное обследование пациентов со спондилоартритами для выявления поражения почек, а также обнаружение и коррекция факторов, способствующих развитию и прогрессированию почечной дисфункции у этой группы пациентов.

spondyloarthritisankylosing spondylitispsoriatic arthritischronic kidney diseaseantirheumatic drugsспондилоартритыанкилозирующий спондилитпсориатический артритхроническая болезнь почекантиревматические препаратыZochling J., Smith E.U. Seronegative Spondyloarthritis. Best Practice and Research. Clinical Rheumatology. 2010;24(6):747–756. https://doi.org/10.1016/j.berh.2011.02.002Stolwijk C., van Onna M., Boonen A., van Tubergen A. Global Prevalence of Spondyloarthritis: A Systematic Review and Meta-Regression Analysis. Arthritis Care and Research (Hoboken). 2016;68(9):1320–1331. https://doi.org/10.1002/acr.22831Molto A., Etcheto A., van der Heijde D., Landewe R., van den Bosch F., Bautista Molano W. et al. Prevalence of Comorbidities and Evaluation of Their Screening in Spondyloarthritis: Results of the International Cross-Sectional ASAS-COMOSPA Study. Annals of the Rheumatic Diseases. 2016;75(6):1016–1023. https://doi.org/10.1136/annrheumdis-2015-208174Couderc M., Pereira B., Molto A., Tiple A., Soubrier M., Dougados M. The Prevalence of Renal Impairment in Patients with Spondyloarthritis: Results from the International ASAS-COMOSPA Study. The Journal of Rheumatology. 2018;45(6):795–801. https://doi.org/10.3899/jrheum.170133Xiao M., Lv Q., Zhang Y., Tu L., Yang M., Lin Z. et al. Spondyloarthritis Patients Suffer Increased Risk of Renal Complications Compared with General Population: A Retrospective Observational Study. Frontiers in Pharmacology. 2019;10:1073. https://doi.org/10.3389/fphar.2019.01073Atzeni F., Muto P., Rodriguez-Carrio J., Masala I.F. Frequency of Renal Function Parameter Abnormalities in Patients with Psoriatic Arthritis and Rheumatoid Arthritis: Real-World Evidence from Clinical Practice. Journal of Clinical Medicine. 2022;11(4):1029. https://doi.org/10.3390/jcm11041029He D., Wang R., Liang S., Liang D., Xu F., Zeng C. et al. Spectrums and Prognosis of Kidney Disease in Patients with Ankylosing Spondylitis. Kidney Diseases (Basel, Switzerland). 2020;6(6):444–452. https://doi.org/10.1159/000509248Wu Y., Zhang G., Wang N., Xue Q. Risk Factors of Renal Involvement Based on Different Manifestations in Patients with Ankylosing Spondylitis. Kidney and Blood Pressure Research. 2018;43(2):367–377. https://doi.org/10.1159/000488071Azevedo D.C., Ferreira G.A., Carvalho M.A. IgA Nephropathy in Patients with Spondyloarthritis Followed-Up at the Rheumatology Service of Hospital das Clinicas/UFMG. Revista Brasileira de Reumatologia. 2011;51(5):417–422. (In Eng., in Portug.). URL: https://pubmed.ncbi.nlm.nih.gov/21952994/Azevedo D.C., Ferreira G.A., Carvalho M.A. IgA Nephropathy in Patients with Spondyloarthritis Followed-up at the Rheumatology Service of Hospital das Clinicas/UFMG. Revista Brasileira de Reumatologia. 2011;51(5):417–422. (In Eng., in Portug.). URL: https://pubmed.ncbi.nlm.nih.gov/21952994/Rodrigues A.C., Marques J.C., Reis M., Gois M., Sousa H., Nolasco F. Kidney Disease in Ankylosing Spondylitis: A Case Series and Review of the Literature. Jornal Brasileiro de Nefrologia. 2023;45(1):36–44. (In Eng., in Portug.). https://doi.org/10.1590/2175-8239-JBN-2022-0008Rodrigues A.C., Marques J.C., Reis M., Gois M., Sousa H., Nolasco F. Kidney Disease in Ankylosing Spondylitis: A Case Series and Review of the Literature. Jornal Brasileiro de Nefrologia. 2023;45(1):36–44. (In Eng., in Portug.). https://doi.org/10.1590/2175-8239-JBN-2022-0008Agrawal N., Mahata R., Chakraborty P.P., Basu K. Secondary Distal Renal Tubular Acidosis and Sclerotic Metabolic Bone Disease in Seronegative Spondyloarthropathy. BMJ Case Reports. 2022;15(3):e248712. https://doi.org/10.1136/bcr-2021-248712Munera-Campos M., Ferrandiz C., Mateo L., Prior-Español A., Carrascosa J.M. Prevalence and Stages of Chronic Kidney Disease in Psoriasis and Psoriatic Arthritis: A Cross-Sectional Study. Indian Journal of Dermatology, Venereology and Leprology. 2021;87(2):321. https://doi.org/10.25259/IJDVL_372_19Chiu H.Y., Huang H.L., Li C.H., Yin Y.J., Chen H.A., Hsu S.T. et al. Increased Risk of Glomerulonephritis and Chronic Kidney Disease in Relation to the Severity of Psoriasis, Concomitant Medication, and Comorbidity: A Nationwide Population-Based Cohort Study. The British Journal of Dermatology. 2015;173(1):146–154. https://doi.org/10.1111/bjd.13599Zhang T., Yang F., Zuo K., Wang J., Cheng Z., Zhang J. HLA-B27 Negativity Is Associated with Renal Function Decline in Patients with Ankylosing Spondylitis and Secondary IgA Nephropathy. Frontiers in Medicine (Lausanne). 2020;7:89. https://doi.org/10.3389/fmed.2020.00089Lee S.H., Lee E.J., Chung S.W., Song R., Moon J.Y., Lee S.H. et al. Renal Involvement in Ankylosing Spondylitis: Prevalence, Pathology, Response to TNF-α Blocker. Rheumatology International. 2013;33(7):1689–1692. https://doi.org/10.1007/s00296-012-2624-9Levy A.R., Szabo S.M., Rao S.R., Cifaldi M., Maksymowych W.P. Estimating the Occurrence of Renal Complications among Persons with Ankylosing Spondylitis. Arthritis Care and Research (Hoboken). 2014;66(3):440–445. https://doi.org/10.1002/acr.22176Roncal C.A., Mu W., Croker B., Reungjui S., Ouyang X., Tabah-Fisch I. et al. Effect of Elevated Serum Uric Acid on Cisplatin-Induced Acute Renal Failure. American Journal of Physiology. Renal Physiology. 2007;292(1):F116–122. https://doi.org/10.1152/ajprenal.00160.2006Barbouch S., Hajji M., Jaziri F., Aoudia R., Fellah E., Hedri H. et al. Renal Amyloidosis in Ankylosing Spondylitis: A Monocentric Study and Review of Literature. Saudi Journal of Kidney Diseases and Transplantation. 2018;29(2):386–391. URL: https://pubmed.ncbi.nlm.nih.gov/29657208/ (accessed: 03.08.2025)Barbouch S., Hajji M., Jaziri F., Aoudia R., Fellah E., Hedri H. et al. Renal Amyloidosis in Ankylosing Spondylitis: A Monocentric Study and Review of Literature. Saudi Journal of Kidney Diseases and Transplantation. 2018;29(2):386–391. URL: https://pubmed.ncbi.nlm.nih.gov/29657208/ (дата обращения: 03.08.2025)Lehtinen K. Mortality and Causes of Death in 398 Patients Admitted to Hospital with Ankylosing Spondylitis. Annals of Rheumatic Diseases. 1993;52(3):174–176. https://doi.org/10.1136/ard.52.3.174Gaisin I.R. International Nomenclature of Antirheumatic Drugs. Therapist’s Bulletin. 2023;56(1):14–19. (In Russ., abstract in Eng.). URL: https://journaltherapy.ru/statyi/mezhdunarodnaja-klassifikacija-antirevmaticheskih-preparatov/ (accessed: 12.06.2025).Гайсин И.Р. Международная классификация антиревматических препаратов. Вестник терапевта. 2023;56(1):14–19. URL: https://journaltherapy.ru/statyi/mezhdunarodnaja-klassifikacija-antirevmaticheskih-preparatov/ (дата обращения: 12.06.2025).Pamuk Ö.N., Kalyoncu U., Aksu K., Omma A., Pehlivan Y., Çağatay Y. et al. A Multicenter Report of Biologic Agents for the Treatment of Secondary Amyloidosis in Turkish Rheumatoid Arthritis and Ankylosing Spondylitis Patients. Rheumatology International. 2016;36(7):945–953. https://doi.org/10.1007/s00296-016-3500-9Champtiaux N., Liote F., El Karoui K., Vigneau C., Miceli C., Cornec-Le Gall E. et al. Spondyloarthritis-Associated IgA Nephropathy. Kidney International Reports. 2020;5(6):813–820. https://doi.org/10.1016/j.ekir.2020.03.012Kim J.W. Are Nonsteroidal Anti-Inflammatory Drugs Safe for the Kidney in Ankylosing Spondylitis? Journal of Rheumatic Diseases. 2023;30(3):139–145. https://doi.org/10.4078/jrd.2023.0033Obeid S., Libby P., Husni E., Wang Q., Wisniewski L.M., Davey D.A. et al. Cardiorenal Risk of Celecoxib Compared with Naproxen or Ibuprofen in Arthritis Patients: Insights from the PRECISION Trial. European Heart Journal. Cardiovascular Pharmacotherapy. 2022;8(6):611–621. https://doi.org/10.1093/ehjcvp/pvac015Tuğsal H.Y., Zengin B., Kenar G., Can G., Ünlü M., Önen F. et al. Infliximab-Associated Focal Segmental Glomerulosclerosis in a Patient with Ankylosing Spondylitis. Rheumatology International. 2019;39(3):561–567. https://doi.org/10.1007/s00296-019-04241-8Corredor D.C., Sanchez de la Nieta M.D., de Lara Simon I.M. Acute Tubulointerstitial Nephritis in an HLA-B27-Positive Patient with Axial Spondyloarthritis Being Treated with Adalimumab. Rheumatologia Clinica. 2019;15(3):179–181. (In Eng., in Span.). https://doi.org/10.1016/j.reuma.2017.03.012Ammar A., Mahmood H.Z.A., Shahid Z., Jain R., Chen G. Etanercept-Associated Nephropathy. Cureus. 2019;11(8):e5419. https://doi.org/10.7759/cureus.5419Coşkun B.N., Yağız B., Çorabay S.G., Pehlivan Y., Dalkılıç E. Anti-TNF Treatment in Ankylosing Spondylitis Patients with Chronic Kidney Disease: Is It Effective and Safe? European Journal of Rheumatology. 2022;9(2):68–74. https://doi.org/10.5152/eurjrheum.2022.21099Coşkun B.N., Yağız B., Çorabay S.G., Pehlivan Y., Dalkılıç E. Anti-TNF Treatment in Ankylosing Spondylitis Patients With Chronic Kidney Disease: Is It Effective and Safe? European Journal of Rheumatology. 2022;9(2):68–74. https://doi.org/10.5152/eurjrheum.2022.21099Swart I.A.P., Visman I.M., Heslinga M., van der Horst-Bruinsma I.E., van Denderen J.C., Nurmohamed M.T. The Effect of Anti-TNF on Renal Function in Patients with Ankylosing Spondylitis: A Prospective Cohort Study. Clinical Rheumatology. 2022;41(12):3747–3752. https://doi.org/10.1007/s10067-022-06330-9Zhou Y., Hu Z. Membranous Lupus Nephritis Secondary to Secukinumab Therapy: A Case Report and Literature Review. Lupus. 2024;33(6):644–649. https://doi.org/10.1177/09612033241242698Ochi M., Toyama T., Ando M., Sato K., Kamikawa Y., Sagara A. et al. A Case of Secondary IgA Nephropathy Accompanied by Psoriasis Treated with Secukinumab. CEN Case Reports. 2019;8(3):200–204. https://doi.org/10.1007/s13730-019-00393-5Segawa Y., Ishida R., Kanehisa F., Nakai K., Morimoto M., Seno M. et al. IgA Nephropathy in a Patient Receiving Infliximab for Generalized Pustular Psoriasis. BMC Nephrology. 2020;21(1):366. https://doi.org/10.1186/s12882-020-02015-0Cao Z., Liu Z., Zhu X., Yang Q., Xu Q., Zhang C. Successful Secukinumab Treatment in Focal Segmental Glomerulosclerosis Associated with Plaque Psoriasis. Renal Failure. 2022;44(1):826–830. https://doi.org/10.1080/0886022X.2022.2073893Gaisin I.R., Kochurov E.K., Gertsen K.A., Maksimov N.I., Benderskaya E.Yu. Cardiovascular System Damage in Psoriatic Arthritis: A Literature Review. Health, Demography, Ecology of Finno-Ugric Peoples. 2024;2:59–64. (In Russ., abstract in Eng.). URL: https://health18.ru/arkhiv?task=download.send&id=46:nomer-2-2024-god&catid=3 (accessed: 12.06.2025).Гайсин И.Р., Кочуров Е.К., Герцен К.А., Максимов Н.И., Бендерская Е.Ю. Поражение сердечно-сосудистой системы при псориатическом артрите: обзор литературы. Здоровье, демография, экология финно-угорских народов. 2024;2:59–64. URL: https://health18.ru/arkhiv?task=download.send&id=46:nomer-2-2024-god&catid=3 (дата обращения: 12.06.2025).Flegal K.M., Kruszon-Moran D., Carroll M.D., Fryar C.D., Ogden C.L. Trends in Obesity Among Adults in the United States, 2005 to 2014. Journal of the American Medical Association. 2016;315(21):2284–2291. https://doi.org/10.1001/jama.2016.6458Friedman A.N., Kaplan L.M., le Roux C.W., Schauer P.R. Management of Obesity in Adults With CKD. Journal of the American Society of Nephrology. 2021;32(4):777–790. https://doi.org/10.1681/ASN.2020101472GBD 2015 Obesity Collaborators; Afshin A., Forouzanfar M.H., Reitsma M.B., Sur P., Estep K., Lee A. et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. The New England Journal of Medicine. 2017;377(1):13–27. https://doi.org/10.1056/NEJMoa1614362Morales E., Porrini E., Martin-Taboada M., Luis-Lima S., Vila-Bedmar R., Gonzalez de Pablos I. et al. Renoprotective Role of Bariatric Surgery in Patients with Established Chronic Kidney Disease. Clinical Kidney Journal. 2020;14(9):2037–2046. https://doi.org/10.1093/ckj/sfaa266Robbins P.D., Jurk D., Khosla S., Kirkland J.L., LeBrasseur N.K., Miller J.D. et al. Senolytic Drugs: Reducing Senescent Cell Viability to Extend Health Span. Annual Review of Pharmacology and Toxicology. 2021;61:779–803. https://doi.org/10.1146/annurev-pharmtox-050120-105018Lair B., Laurens C., Van Den Bosch B., Moro C. Novel Insights and Mechanisms of Lipotoxicity-Driven Insulin Resistance. International Journal of Molecular Sciences. 2020;21(17):6358. https://doi.org/10.3390/ijms21176358Tzanavari T., Giannogonas P., Karalis K.P. TNF-alpha and Obesity. Current Directions in Autoimmunity. 2010;11:145–156. https://doi.org/10.1159/000289203Weisberg S.P., McCann D., Desai M., Rosenbaum M., Leibel R.L., Ferrante A.W.Jr. Obesity Is Associated with Macrophage Accumulation in Adipose Tissue. The Journal of Clinical Investigation. 2003;112(12):1796–1808. https://doi.org/10.1172/JCI19246Weisberg S.P., McCann D., Desai M., Rosenbaum M., Leibel R.L., Ferrante A.W.Jr. Obesity Is Associated With Macrophage Accumulation in Adipose Tissue. The Journal of Clinical Investigation. 2003;112(12):1796–1808. https://doi.org/10.1172/JCI19246Lee B.T., Ahmed F.A., Hamm L.L., Teran F.J., Chen C.S., Liu Y. et al. Association of C-Reactive Protein, Tumor Necrosis Factor-Alpha, and Interleukin-6 with Chronic Kidney Disease. BMC Nephrology. 2015;16:77. https://doi.org/10.1186/s12882-015-0068-7Moriconi D., Antonioli L., Masi S., Bellini R., Pellegrini C., Rebelos E. et al. Glomerular Hyperfiltration in Morbid Obesity: Role of the Inflammasome Signalling. Nephrology (Carlton). 2022;27(8):673–680. https://doi.org/10.1111/nep.14077Niu H., Li Y., Li H., Chi Y., Zhuang M., Zhang T. et al. Matrix Metalloproteinase 12 Modulates High-Fat-Diet Induced Glomerular Fibrogenesis and Inflammation in a Mouse Model of Obesity. Scientific Reports. 2016;6:20171. https://doi.org/10.1038/srep20171Halberg N., Khan T., Trujillo M.E., Wernstedt-Asterholm I., Attie A.D., Sherwani S. et al. Hypoxia-Inducible Factor 1Alpha Induces Fibrosis and Insulin Resistance in White Adipose Tissue. Molecular and Cellular Biology. 2009;29(16):4467–4483. https://doi.org/10.1128/MCB.00192-09Sun K., Halberg N., Khan M., Magalang U.J., Scherer P.E. Selective Inhibition of Hypoxia-Inducible Factor 1α Ameliorates Adipose Tissue Dysfunction. Molecular and Cellular Biology. 2013;33(5):904–917. https://doi.org/10.1128/MCB.00951-12Kane H., Lynch L. Innate Immune Control of Adipose Tissue Homeostasis. Trends in Immunology. 2019;40(9):857–872. https://doi.org/10.1016/j.it.2019.07.006Arcidiacono B., Chiefari E., Foryst-Ludwig A., Curro G., Navarra G., Brunetti F.S. et al. Obesity-Related Hypoxia via MiR-128 Decreases Insulin-Receptor Expression in Human and Mouse Adipose Tissue Promoting Systemic Insulin Resistance. EBioMedicine. 2020;59:102912. https://doi.org/10.1016/j.ebiom.2020.102912Zhao H.L., Sui Y., Guan J., He L., Zhu X., Fan R.R. et al. Fat Redistribution and Adipocyte Transformation in Uninephrectomized Rats. Kidney International. 2008;74(4):467–477. https://doi.org/10.1038/ki.2008.195Roubicek T., Bartlova M., Krajickova J., Haluzikova D., Mraz M., Lacinova Z. et al. Increased Production of Proinflammatory Cytokines in Adipose Tissue of Patients with End-Stage Renal Disease. Nutrition. 2009;25(7–8):762–768. https://doi.org/10.1016/j.nut.2008.12.012Kalbacher E., Koppe L., Zarrouki B., Pillon N.J., Fouque D., Soulage C.O. Human Uremic Plasma and Not Urea Induces Exuberant Secretion of Leptin in 3T3-L1 Adipocytes. Journal of Renal Nutrition. 2011;21(1):72–75. https://doi.org/10.1053/j.jrn.2010.11.009Axelsson J., Aström G., Sjölin E., Qureshi A.R., Lorente-Cebrian S., Stenvinkel P. et al. Uraemic Sera Stimulate Lipolysis in Human Adipocytes: Role of Perilipin. Nephrology, Dialysis, Transplantation. 2011;26(8):2485–2491. https://doi.org/10.1093/ndt/gfq755D’Apolito M., Du X., Zong H., Catucci A., Maiuri L., Trivisano T. et al. Urea-Induced ROS Generation Causes Insulin Resistance in Mice with Chronic Renal Failure. The Journal of Clinical Investigation. 2010;120(1):203–213. https://doi.org/10.1172/JCI37672Bellasi A., Di Micco L., Santoro D., Marzocco S., De Simone E., Cozzolino M. et al. Correction of Metabolic Acidosis Improves Insulin Resistance in Chronic Kidney Disease. BMC Nephrology. 2016;17(1):158. https://doi.org/10.1186/s12882-016-0372-xArabi T., Shafqat A., Sabbah B.N., Ashraf N., Shah H., Abdulkader H. et al. Obesity-Related Kidney Disease: Beyond Hypertension and Insulin-Resistance. Frontiers in Endocrinology (Lausanne). 2023;13:1095211. https://doi.org/10.3389/fendo.2022.1095211Cumin F., Baum H.P., Levens N. Leptin Is Cleared from the Circulation Primarily by the Kidney. International Journal of Obesity and Related Metabolic Disorders. 1996;20(12):1120–1126. URL: https://pubmed.ncbi.nlm.nih.gov/8968858/Alix P.M., Guebre-Egziabher F., Soulage C.O. Leptin as an Uremic Toxin: Deleterious Role of Leptin in Chronic Kidney Disease. Biochimie. 2014;105:12–21. https://doi.org/10.1016/j.biochi.2014.06.024Yanai H., Yoshida H. Beneficial Effects of Adiponectin on Glucose and Lipid Metabolism and Atherosclerotic Progression: Mechanisms and Perspectives. International Journal of Molecular Sciences. 2019;20(5):1190. https://doi.org/10.3390/ijms20051190Zhu Q., Scherer P.E. Immunologic and Endocrine Functions of Adipose Tissue: Implications for Kidney Disease. Nature Reviews. Nephrology. 2018;14(2):105–120. https://doi.org/10.1038/nrneph.2017.157Holland W.L., Xia J.Y., Johnson J.A., Sun K., Pearson M.J., Sharma A.X. et al. Inducible Overexpression of Adiponectin Receptors Highlight the Roles of Adiponectin-Induced Ceramidase Signaling in Lipid and Glucose Homeostasis. Molecular Metabolism. 2017;6(3):267–275. https://doi.org/10.1016/j.molmet.2017.01.002Mantovani A., Lunardi G., Bonapace S., Dugo C., Altomari A., Molon G. et al. Association Between Increased Plasma Ceramides and Chronic Kidney Disease in Patients with and without Ischemic Heart Disease. Diabetes and Metabolism. 2021;47(1):101152. https://doi.org/10.1016/j.diabet.2020.03.003Summers S.A. Ceramides in Insulin Resistance and Lipotoxicity. Progress in Lipid Research. 2006;45(1):42–72. https://doi.org/10.1016/j.plipres.2005.11.002Yang J., Lin S.C., Chen G., He L., Hu Z., Chan L. et al. Adiponectin Promotes Monocyte-To-Fibroblast Transition in Renal Fibrosis. Journal of the American Society of Nephrology. 2013;24(10):1644–1659. https://doi.org/10.1681/ASN.2013030217Perri A., Vizza D., Lupinacci S., Toteda G., De Amicis F., Leone F. et al. Adiponectin Secreted by Tubular Renal Cells During LPS Exposure Worsens the Cellular Inflammatory Damage. Journal of Nephrology. 2016;29(2):185–194. https://doi.org/10.1007/s40620-015-0220-2Gwinnutt J.M., Wieczorek M., Balanescu A., Bischoff-Ferrari H.A., Boonen A., Cavalli G. et al. 2021 EULAR Recommendations Regarding Lifestyle Behaviours and Work Participation to Prevent Progression of Rheumatic and Musculoskeletal Diseases. Annals of the Rheumatic Diseases. 2023;82(1):48–56. https://doi.org/10.1136/annrheumdis-2021-222020