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Visfatin, also known as pre–B-cell colony–enhancing factor 1 (PBEF-1), recently was shown to be secreted from adipocytes and have insulin-mimetic properties in mice. Because renal failure per se is associated with both increased levels of circulating peptides and marked insulin resistance, even in the absence of diabetes mellitus, we hypothesized that visfatin could be a factor linking inflammation, kidney disease, and insulin resistance in this patient group.

Altogether, we studied 189 patients with chronic kidney disease (CKD), comprising 149 patients with CKD stage 5 (glomerular filtration rate [GFR] < 15 mL/min; mean, 7 ± 2 mL/min [<0.25 mL/s; mean, 0.12 ± 0.03 mL/s]; 61% men; mean age, 54 ± 12 years) and 40 patients with CKD stages 3 to 4 (GFR, 15 to 60 mL/min; mean, 33 ± 21 mL/min [0.25 to 1.00 mL/s; mean, 0.55 ± 0.35 mL/s]; 72% men; age, 59 ± 15 years). We compared …