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International Urology and Nephrology
Published in: International Urology and Nephrology 3/2011

01-09-2011 | Nephrology – Review

The role of obesity in kidney disease: recent findings and potential mechanisms

Authors: Rigas G. Kalaitzidis, Kostas C. Siamopoulos

Published in: International Urology and Nephrology | Issue 3/2011

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Abstract

Obesity epidemic is in rise in almost every industrialized country and continues to be a growing problem worldwide. In fact, obesity per se has been recognized as a chronic disease. Consequently, there has been a cascade of metabolic changes initiated by the markedly risen prevalence that contributes to the increased incidence of diabetes, hypertension, and cardiovascular disease. Moreover, obesity is also associated with an increased risk of chronic kidney disease (CKD). The majority of the studies indicate a direct relationship between body mass index (BMI) and CKD risk. Moreover, current evidence emphasized the fact that central obesity measurements, such as waist circumference, could be a better predictor of CKD progression and mortality than BMI. The detrimental effects of obesity on kidney outcome have been recognized in nondialysis-dependent (NDD)-CKD patients. However, survival in overweight or obese CKD patients undergoing maintenance hemodialysis is paradoxically opposed compared with the general population. This “reverse epidemiology,” however, is valid mainly for the inflammated end-stage renal disease (ESRD) patients. In fact, renal transplant recipients with higher BMI have inferior patient and graft survival compared to patients with lower BMI. This review also provides perspectives concerning the mechanisms associated with obesity, such as the renin–angiotensin–aldosterone system (RAAS) activation, and the role of leptin, adiponectin, fetuin-A, and adipose tissue, as factors that contribute to the development of CKD. Prevention strategies for CKD patients are also discussed and should be considered by clinicians.
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Metadata
Title
The role of obesity in kidney disease: recent findings and potential mechanisms
Authors
Rigas G. Kalaitzidis
Kostas C. Siamopoulos
Publication date
01-09-2011
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2011
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-011-9974-1

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