More than skin deep? Potential nicotinamide treatment applications in chronic kidney transplant recipients

Figure 1 The unique aggressiveness of squamous cell carcinoma in kidney transplant recipients. Deeply invasive, recurrent, poorly differentiated and ulcerated squamous cell carcinoma in a 73-year-old female kidney transplant recipient with background alopecia from prior radiation therapy for this squamous cell carcinoma.

Figure 2 Nicotinamide-SIRT binding. At high concentrations, NAM can bind to SIRT when it contains the O-alkyl-amidate intermediate, resulting in “NAM exchange”, reforming NAD⁺ and acetyl-lysine, and decreasing deacetylation activity - a process unique to NAM, not NA. Reproduced from[18]. NA: Nicotinic acid; NAM: Nicotinamide.

Figure 3 Phosphorus-lowering effect of nicotinic acid in chronic kidney disease. Mean serum phosphorus concentrations in dyslipidemic patients with stage 3 chronic kidney disease receiving extended release niacin-laropiprant, or placebo. Error bars are standard errors. Reproduced from Ref. [24].