INS and chronic kidney disease: Leptin is an adipokine that is associated with insulin resistance, inflammation, and oxidative stress.49 Adiponectin is an anti-inflammatory adipokine that enhances insulin sensitivity.49 A high leptin-adiponectin ratio is associated with CKD,49 and adiponectin reduces CKD risk.50 SGLT2-inhibitors significantly decrease leptin and increase adiponectin levels in clinical trials involving patients with type 2 diabetes.51 Mechanisms underlying these findings have not been fully elucidated.