Visfatin, an adipocyte derived polypeptide hormone, is expressed preferentially in visceral fat.73, 74Serum visfatin is associated with increased endothelial dysfunction seen in all stages of CKD, which is independent of insulin resistance and inflammation. It associates independently with VCAM‐1; a marker of damage to endothelia.75In patients with CKD, higher levels of visfatin are associated with lower GFR, and increased triglyceride and low‐density lipoprotein; it is also proatherogenic in nature.76 Here, VCAM1 is linked to Insulin resistance.