Serum Endocannabinoid Levels in Patients With End-Stage Renal Disease

Context: Previous studies have shown that the endocannabinoid system plays
a major role in energy metabolism through the actions of its main
mediators, 2-arachidonoyl-sn-glycerol (2-AG) and anandamide (AEA).
Objective: We examined serum levels of major endocannabinoid mediators and
their association with clinical parameters in patients with end-stage
renal disease (ESRD). Design and Setting: Serum concentrations of 2-AG and
AEA were measured in patients on maintenance hemodialysis (MHD), and
correlations with various clinical and laboratory indices were examined.
For comparison of levels in patients undergoing MHD, 2-AG was also
measured in age and sex-matched healthy subjects. Main Outcome Measure:
Serum 2-AG. Results: Serum 2-AG levels were significantly elevated in
patients with ESRD compared with healthy controls. Highest levels
of 2-AG were found in patients on MHD, and similar findings were seen in a
second set of subjects in independent analyses. Among 96 patients on MHD,
2-AG levels correlated significantly and positively with serum
triglycerides (ρ=0.43; P <0.0001), body mass index (ρ=0.40; P
<0.0001), and body anthropometric measures and negatively with
serum high-density lipoprotein cholesterol (ρ= -0.33; P =0.001) following
adjustment for demographic and clinical variables. Conclusions: In
patients on MHD, levels of serum 2-AG, a major endocannabinoid
mediator, were increased. In addition, increasing serum 2-AG levels
correlated with increased serum triglycerides and markers of body mass.
Future studies will need to evaluate the potential mechanisms responsible
for these findings.