A review of biological function of the explored and unexplored adipokines from normal to cancerous kidney

INTRODUCTION: Adipokines are bioactive signaling molecules secreted from adipose tissue (AT) that have regulatory functions in maintaining metabolic homeostasis. In physiological conditions, balanced adipokine secretion supports metabolic stability and organ function. However, disruption of this balance can promote chronic inflammation and increase cancer risk. While their role in normal physiology is recognized, biological functions of adipokines in renal cell carcinoma (RCC) remain partially understood. AREAS COVERED: This review explores the biological functions of key adipokines such as adiponectin, leptin, visfatin, nesfatin-1, apelin, and omentin-1 in normal cellular processes and RCC. A search of the literature on PubMed, Web of Science, and Embase databases was performed from January 2000 through April 2025. This review summarizes findings on how these adipokines influence tumor biology, with a specific focus on their emerging roles in RCC. The review includes new findings and their possible limitations and the complexity of adipokine signaling and their roles in promoting or inhibiting tumorigenesis. EXPERT OPINION: The current evidence highlights adipokines as promising mediators in RCC biology; however, their mechanisms of action remain unclear. Further mechanistic studies are essential to unravel how adipokines regulate tumor initiation and progression. Without such understanding, the rational design of targeted therapies remains limited.