While HHD diagnosis in a CKD patient for more than 6 years may compensate for the aberrant kidney's reduced ability to take up leptin from circulation,53, 54 it is quite unclear whether such reductions in serum leptin levels could predict improved outcomes in CKD patients diagnosed with HHD, as proposed by Scholze et al.48This is because HHD on its own is not connected with any favorable outcomes.19, 55. Here, LEP is linked to chronic kidney disease.