Neuropeptide Y (NPY) is a 36-amino-acid peptide member of a family also including peptide YY and pancreatic polypeptide, which are all ligands to Gi/Go coupled receptors. NPY regulates several fundamental biologic functions including appetite/satiety, sex and reproduction, learning and memory, cardiovascular and renal function and immune functions. The mesenteric circulation is a major source of NPY in the blood in man and this peptide is considered a key regulator of gut-brain cross talk. A progressive increase in circulating NPY accompanies the progression of chronic kidney disease (CKD) toward kidney failure and NPY robustly predicts cardiovascular events in this population. Furthermore, NPY is suspected as a possible player in accelerated cognitive function decline and dementia in patients with CKD and in dialysis patients. In theory, interfering with the NPY system has relevant potential for the treatment of diverse diseases from cardiovascular and renal diseases to diseases of the central nervous system. Pharmaceutical formulations for effective drug delivery and cost, as well as the complexity of diseases potentially addressable by NPY/NPY antagonists, have been a problem until now. This in part explains the slow progress of knowledge about the NPY system in the clinical arena. There is now renewed research interest in the NPY system in psychopharmacology and in pharmacology in general and new studies and a new breed of clinical trials may eventually bring the expected benefits in human health with drugs interfering with this system.

3rd Faculty of Medicine Department of Medicine Charles University and Faculty Hospital Kralovske Vinohrady Prague Czech Republic

Associazione Ipertensione Nefrologia Trapianto Renale Reggio Cal Italy

Biogem Scarl Ariano Irpino Italy

c o CNR IFC Ospedali Riuniti Reggio Calabria Italy

CNR IFC Reggio Calabria Italy

Department of Advanced Medical and Surgical Sciences and 3T MRI Research Center University of Campania 'Luigi Vanvitelli' Naples Italy

Department of Health Medicine and Caring Sciences Linköping University Linköping Sweden and Department of Renal Medicine CLINTEC Karolinska Institutet Stockholm Sweden

Department of Nephrology Dialysis and Internal Medicine Warsaw Medical University Warsaw Poland

Department of Nephrology Faculty of Medicine University of Medicine Tirana Tirana Albania

Department of Nephrology Hacettepe University School of Medicine Ankara Turkey

Department of Nephrology Transplantation and Internal Medicine Medical University of Silesia in Katowice Katowice Poland

Department of Nephrology University 'Sts Cyril and Methodius' Skopje MK Republic of Macedonia

Department of Translational Medical Sciences University of Campania 'Luigi Vanvitelli' Naples Italy

Division of Nephrology and Center for Immunity Inflammation and Regenerative Medicine University of Virginia Charlottesville VA USA

Faculty of Life Sciences Institute of Biochemistry Leipzig University Leipzig Germany

Health and Bioresources Biomedical Systems Austrian Institute of Technology Vienna Austria

Institute of Anatomy University of Zurich Zurich Switzerland

Istituto di Ricerche Farmacologiche Mario Negri IRCCS Clinical Research Center for Rare Diseases Aldo e Cele Daccò Bergamo Italy

Nephrology and Transplantation Unit Grande Ospedale Metropolitano and CNR IFC Reggio Calabria Italy

Nephrology Department Lithuanian University of Health Sciences Kaunas Lithuania

Neurology Department Lithuanian University of Health Sciences Kaunas Lithuania

Neurology Department San Raffaele Scientific Institute and Vita Salute University San Raffaele Milan Italy

Renal Research Institute New York NY USA

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