Journal
NUTRIENTS
Volume 13, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/nu13124482
Keywords
obesity; fatty kidney; glomerulopathy; CKD; ESRD; bariatric surgery
Categories
Funding
- CIBER Fisiopatologia Obesidad y Nu-tricion [CB06/03]
- Instituto de Salud Carlos III, Spain [PI11/00144, PI14/01781]
- Instituto de Salud Carlos III
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Obesity is closely related to renal damage, and weight reduction is key in limiting the impact on kidneys, reducing albuminuria/proteinuria, slowing down the decline in renal function, delaying the development of CKD, and improving outcomes of renal transplantation.
The clinical consequences of obesity on the kidneys, with or without metabolic abnormalities, involve both renal function and structures. The mechanisms linking obesity and renal damage are well understood, including several effector mechanisms with interconnected pathways. Higher prevalence of urinary albumin excretion, sub-nephrotic syndrome, nephrolithiasis, increased risk of developing CKD, and progression to ESKD have been identified as being associated with obesity and having a relevant clinical impact. Moreover, renal replacement therapy and kidney transplantation are also influenced by obesity. Losing weight is key in limiting the impact that obesity produces on the kidneys by reducing albuminuria/proteinuria, declining rate of eGFR deterioration, delaying the development of CKD and ESKD, and improving the outcome of a renal transplant. Weight reduction may also contribute to appropriate control of cardiometabolic risk factors such as hypertension, metabolic syndrome, diabetes, and dyslipidemia which may be protective not only in renal damage but also cardiovascular disease. Lifestyle changes, some drugs, and bariatric surgery have demonstrated the benefits.
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