However, the mechanism by which adiponectin increases in renal failure has not been clarified and the clinical significance of plasma adiponectin level in patients with moderate renal dysfunction is controversial: in vitro studies indicated that adiponectin binds to cystatin C, an inhibitor of the cathepsin family, which abrogates, in a dose-dependent manner, the suppressive effects of adiponectin on adhesion molecules induced by TNF-α-induced [97]. This evidence concerns the gene ADIPOQ and kidney failure.