Abstrakt

Obesity and chronic kidney disease: therapeutic implications

Poorna R Karuparthi, Preethi Yerram, Georges Saab, Samy I McFarlane and Adam Whaley-Connell

Obesity has now reached epidemic proportions, with far-reaching healthcare and economic implications. Obesity has been associated with end-organ damage in several tissues including the kidney and is one of the most important modifiable and preventable causes of death. Insulin resistance and the compensatory hyperinsulinemia, oxidative stress and adipocytokines, among others, have been implicated in the causation of obesity-related kidney damage. Obesity-related focal glomerulosclerosis is now a well recognized distinct histopathological entity and its pathophysiology has been related to the ‘hyperfiltration’ mechanism associated with increased renal plasma flow and glomerular filtration rate. This review will discuss the epidemiology and pathophysiology of obesity-related kidney damage with special focus on the central role of insulin resistance/hyperinsulinemia, adipocytokines and oxidative stress, as well as summarize the current evidence and recommendations in the management of this condition.