Skip to main content
Top
Published in: Current Diabetes Reports 4/2012

01-08-2012 | Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Pathophysiology of Obesity-Related Renal Dysfunction Contributes to Diabetic Nephropathy

Authors: George Bayliss, Larry A. Weinrauch, John A. D’Elia

Published in: Current Diabetes Reports | Issue 4/2012

Login to get access

Abstract

Recent studies have demonstrated the role of insulin resistance in renal injury related to obesity, with hyperfiltration leading to glomerulomegaly in a pattern similar to that found in diabetic nephropathy. Similarities in the histologic patterns of damage from obesity and diabetes point to overlapping mechanisms of injury. In this review, we will examine the hormonal mechanisms, signaling pathways and injury patterns in renal injury resulting from obesity and attempt to draw conclusions on the reasons for these similarities.
Literature
1.
go back to reference Preble WE. Obesity: Observation on one thousand cases. Boston Med Surg J. 1923;188:617–21.CrossRef Preble WE. Obesity: Observation on one thousand cases. Boston Med Surg J. 1923;188:617–21.CrossRef
2.
go back to reference Weisinger JR, Kempson RL, Eldridge FL, Swenson RS. The nephrotic syndrome: a complication of massive obesity. Ann Intern Med. 1974;81:440–7.PubMed Weisinger JR, Kempson RL, Eldridge FL, Swenson RS. The nephrotic syndrome: a complication of massive obesity. Ann Intern Med. 1974;81:440–7.PubMed
3.
go back to reference Cohen AH. Massive obesity and the kidney. A morphologic and statistical study. Am J Pathol. 1975;81:117–30.PubMed Cohen AH. Massive obesity and the kidney. A morphologic and statistical study. Am J Pathol. 1975;81:117–30.PubMed
4.
go back to reference Verani RR. Obesity-associated focal segmental glomerulosclerosis: pathological features of the lesion and relationship with cardiomegaly and hyperlipidemia. Am J Kidney Dis. 1992;20:629–34.PubMed Verani RR. Obesity-associated focal segmental glomerulosclerosis: pathological features of the lesion and relationship with cardiomegaly and hyperlipidemia. Am J Kidney Dis. 1992;20:629–34.PubMed
5.
go back to reference Kambham N, Markowitz GS, Valeri AM, et al. VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59:1498–509.PubMedCrossRef Kambham N, Markowitz GS, Valeri AM, et al. VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59:1498–509.PubMedCrossRef
6.
go back to reference Fox CS, Larson MG, Leip EP, et al. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291:844–50.PubMedCrossRef Fox CS, Larson MG, Leip EP, et al. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291:844–50.PubMedCrossRef
7.
go back to reference Morales E, Valero MA, Leon M, et al. Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Am J Kidney Dis. 2003;41:319–27.PubMedCrossRef Morales E, Valero MA, Leon M, et al. Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Am J Kidney Dis. 2003;41:319–27.PubMedCrossRef
8.
go back to reference Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA. 2004;291:2013–6.PubMedCrossRef Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA. 2004;291:2013–6.PubMedCrossRef
9.
go back to reference Chaudhary BA, Sklar AH, Chaudhary TK, et al. Sleep apnea, proteinuria, and nephrotic syndrome. Sleep. 1988;11:69–74.PubMed Chaudhary BA, Sklar AH, Chaudhary TK, et al. Sleep apnea, proteinuria, and nephrotic syndrome. Sleep. 1988;11:69–74.PubMed
10.
go back to reference Sklar AH, Chaudhary BA. Reversible proteinuria in obstructive sleep apnea syndrome. Arch Intern Med. 1988;148:87–9.PubMedCrossRef Sklar AH, Chaudhary BA. Reversible proteinuria in obstructive sleep apnea syndrome. Arch Intern Med. 1988;148:87–9.PubMedCrossRef
11.
go back to reference Sklar AH, Chaudhary BA, Harp R. Nocturnal urinary protein excretion rates in patients with sleep apnea. Nephron. 1989;51:35–8.PubMedCrossRef Sklar AH, Chaudhary BA, Harp R. Nocturnal urinary protein excretion rates in patients with sleep apnea. Nephron. 1989;51:35–8.PubMedCrossRef
12.
go back to reference Tsioufis C, Thomopoulos C, Dimitriadis K, et al. Association of obstructive sleep apnea with urinary albumin excretion in essential hypertension: a cross-sectional study. Am J Kidney Dis. 2008;52:285–93.PubMedCrossRef Tsioufis C, Thomopoulos C, Dimitriadis K, et al. Association of obstructive sleep apnea with urinary albumin excretion in essential hypertension: a cross-sectional study. Am J Kidney Dis. 2008;52:285–93.PubMedCrossRef
13.
go back to reference Casserly LF, Chow N, Ali S, et al. Proteinuria in obstructive sleep apnea. Kidney Int. 2001;60:1484–9.PubMedCrossRef Casserly LF, Chow N, Ali S, et al. Proteinuria in obstructive sleep apnea. Kidney Int. 2001;60:1484–9.PubMedCrossRef
14.
go back to reference • Chou YT, Lee PH, Yang CT, et al. Obstructive sleep apnea: a stand-alone risk factor for chronic kidney disease. Nephrol Dial Transplant. 2011;26:2244–50. This article discusses the relationship of sleep apnea, insulin resistance and proteinuria.PubMedCrossRef • Chou YT, Lee PH, Yang CT, et al. Obstructive sleep apnea: a stand-alone risk factor for chronic kidney disease. Nephrol Dial Transplant. 2011;26:2244–50. This article discusses the relationship of sleep apnea, insulin resistance and proteinuria.PubMedCrossRef
15.
go back to reference Hall JE. Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens. 1997;10:49S–55S.PubMedCrossRef Hall JE. Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens. 1997;10:49S–55S.PubMedCrossRef
16.
go back to reference Chagnac A, Weinstein T, Korzets A, et al. Glomerular hemodynamics in severe obesity. Am J Physiol Ren Physiol. 2000;278:F817–22. Chagnac A, Weinstein T, Korzets A, et al. Glomerular hemodynamics in severe obesity. Am J Physiol Ren Physiol. 2000;278:F817–22.
17.
go back to reference Chagnac A, Weinstein T, Herman M, et al. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol: JASN. 2003;14:1480–6.PubMedCrossRef Chagnac A, Weinstein T, Herman M, et al. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol: JASN. 2003;14:1480–6.PubMedCrossRef
18.
go back to reference Chagnac A, Herman M, Zingerman B, et al. Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption. Nephrol Dial Transplant. 2008;23:3946–52.PubMedCrossRef Chagnac A, Herman M, Zingerman B, et al. Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption. Nephrol Dial Transplant. 2008;23:3946–52.PubMedCrossRef
19.
go back to reference Ix JH, Sharma K. Mechanisms linking obesity, chronic kidney disease, and fatty liver disease: the roles of fetuin-A, adiponectin, and AMPK. J Am Soc Nephrol: JASN. 2010;21:406–12.PubMedCrossRef Ix JH, Sharma K. Mechanisms linking obesity, chronic kidney disease, and fatty liver disease: the roles of fetuin-A, adiponectin, and AMPK. J Am Soc Nephrol: JASN. 2010;21:406–12.PubMedCrossRef
20.
go back to reference Hennige AM, Staiger H, Wicke C, et al. Fetuin-A induces cytokine expression and suppresses adiponectin production. PLoS One. 2008;3:e1765.PubMedCrossRef Hennige AM, Staiger H, Wicke C, et al. Fetuin-A induces cytokine expression and suppresses adiponectin production. PLoS One. 2008;3:e1765.PubMedCrossRef
21.
go back to reference Ix JH, Shlipak MG, Brandenburg VM, et al. Association between human fetuin-A and the metabolic syndrome: Data from the Heart and Soul Study. Circulation. 2006;113:1760–7.PubMedCrossRef Ix JH, Shlipak MG, Brandenburg VM, et al. Association between human fetuin-A and the metabolic syndrome: Data from the Heart and Soul Study. Circulation. 2006;113:1760–7.PubMedCrossRef
22.
go back to reference Laughlin GA, Barrett-Connor E, May S, Langenberg C. Association of adiponectin with coronary heart disease and mortality: the Rancho Bernardo study. Am J Epidemiol. 2007;165:164–74.PubMedCrossRef Laughlin GA, Barrett-Connor E, May S, Langenberg C. Association of adiponectin with coronary heart disease and mortality: the Rancho Bernardo study. Am J Epidemiol. 2007;165:164–74.PubMedCrossRef
23.
go back to reference Sharma K, Ramachandrarao S, Qiu G, et al. Adiponectin regulates albuminuria and podocyte function in mice. J Clin Invest. 2008;118:1645–56.PubMed Sharma K, Ramachandrarao S, Qiu G, et al. Adiponectin regulates albuminuria and podocyte function in mice. J Clin Invest. 2008;118:1645–56.PubMed
24.
go back to reference Baumann M, von Eynatten M, Dan L, et al. Altered molecular weight forms of adiponectin in hypertension. J Clin Hypertens. 2009;11:11–6.CrossRef Baumann M, von Eynatten M, Dan L, et al. Altered molecular weight forms of adiponectin in hypertension. J Clin Hypertens. 2009;11:11–6.CrossRef
25.
go back to reference Iwashima Y, Horio T, Kumada M, et al. Adiponectin and renal function, and implication as a risk of cardiovascular disease. Am J Cardiol. 2006;98:1603–8.PubMedCrossRef Iwashima Y, Horio T, Kumada M, et al. Adiponectin and renal function, and implication as a risk of cardiovascular disease. Am J Cardiol. 2006;98:1603–8.PubMedCrossRef
26.
go back to reference Pineiro R, Iglesias MJ, Gallego R, et al. Adiponectin is synthesized and secreted by human and murine cardiomyocytes. FEBS Lett. 2005;579:5163–9.PubMedCrossRef Pineiro R, Iglesias MJ, Gallego R, et al. Adiponectin is synthesized and secreted by human and murine cardiomyocytes. FEBS Lett. 2005;579:5163–9.PubMedCrossRef
27.
go back to reference Saginova EA, Galliamov MG, Severova MM, et al. The role of leptin, adiponectin and insulin-resistance markers in development of early stages of chronic kidney disease and atherosclerosis of carotid arteries in obese patients. Ter Arkh. 2011;83:47–53.PubMed Saginova EA, Galliamov MG, Severova MM, et al. The role of leptin, adiponectin and insulin-resistance markers in development of early stages of chronic kidney disease and atherosclerosis of carotid arteries in obese patients. Ter Arkh. 2011;83:47–53.PubMed
28.
go back to reference Ellington AA, Malik AR, Klee GG, et al. Association of plasma resistin with glomerular filtration rate and albuminuria in hypertensive adults. Hypertension. 2007;50:708–14.PubMedCrossRef Ellington AA, Malik AR, Klee GG, et al. Association of plasma resistin with glomerular filtration rate and albuminuria in hypertensive adults. Hypertension. 2007;50:708–14.PubMedCrossRef
29.
go back to reference Coward R, Walsh GI, Koziell A, et al. Nephrin is critical for the action of insulin on human glomerular podocytes. Diabetes. 2007;56:1127–35.PubMedCrossRef Coward R, Walsh GI, Koziell A, et al. Nephrin is critical for the action of insulin on human glomerular podocytes. Diabetes. 2007;56:1127–35.PubMedCrossRef
30.
go back to reference Jones N, Blasutig IM, Eremina V, et al. Nck adaptor proteins link nephrin to the actin cytoskeleton of kidney podocytes. Nature. 2006;440:818–23.PubMedCrossRef Jones N, Blasutig IM, Eremina V, et al. Nck adaptor proteins link nephrin to the actin cytoskeleton of kidney podocytes. Nature. 2006;440:818–23.PubMedCrossRef
31.
go back to reference • Fornoni A, Jeon J, Varona Santos J, et al. Nephrin is expressed on the surface of insulin vesicles and facilitates glucose-stimulated insulin releases. Diabetes. 2010;59:190–9. This article discusses the role of nephrin, an important glomerular protein, in secretion of insulin vessicles in the pancreas.PubMedCrossRef • Fornoni A, Jeon J, Varona Santos J, et al. Nephrin is expressed on the surface of insulin vesicles and facilitates glucose-stimulated insulin releases. Diabetes. 2010;59:190–9. This article discusses the role of nephrin, an important glomerular protein, in secretion of insulin vessicles in the pancreas.PubMedCrossRef
32.
go back to reference Hussain S, Romio L, Saleem M, et al. Nephrin deficiency activates NF-kappaB and promotes glomerular injury. J Am Soc Nephrol: JASN. 2009;20:1733–43.PubMedCrossRef Hussain S, Romio L, Saleem M, et al. Nephrin deficiency activates NF-kappaB and promotes glomerular injury. J Am Soc Nephrol: JASN. 2009;20:1733–43.PubMedCrossRef
33.
go back to reference Nagase M, Yoshida S, Shibata S, et al. Enhanced aldosterone signaling in the early nephropathy of rats with metabolic syndrome: possible contribution of fat-derived factors. J Am Soc Nephrol: JASN. 2006;17:3438–46.PubMedCrossRef Nagase M, Yoshida S, Shibata S, et al. Enhanced aldosterone signaling in the early nephropathy of rats with metabolic syndrome: possible contribution of fat-derived factors. J Am Soc Nephrol: JASN. 2006;17:3438–46.PubMedCrossRef
34.
go back to reference Sharma R, Sharma M, Reddy S, et al. Chronically increased intrarenal angiotensin II causes nephropathy in an animal model of type 2 diabetes. Front Biosci. 2006;11:968–76.PubMedCrossRef Sharma R, Sharma M, Reddy S, et al. Chronically increased intrarenal angiotensin II causes nephropathy in an animal model of type 2 diabetes. Front Biosci. 2006;11:968–76.PubMedCrossRef
35.
go back to reference Callera GE, Touyz RM, Tostes RC, et al. Aldosterone activates vascular p38MAP kinase and NADPH oxidase via c-Src. Hypertension. 2005;45:773–9.PubMedCrossRef Callera GE, Touyz RM, Tostes RC, et al. Aldosterone activates vascular p38MAP kinase and NADPH oxidase via c-Src. Hypertension. 2005;45:773–9.PubMedCrossRef
36.
go back to reference Ehrhart-Bornstein M, Lamounier-Zepter V, Schraven A, et al. Human adipocytes secrete mineralocorticoid-releasing factors. Proc Natl Acad Sci U S A. 2003;100:14211–6.PubMedCrossRef Ehrhart-Bornstein M, Lamounier-Zepter V, Schraven A, et al. Human adipocytes secrete mineralocorticoid-releasing factors. Proc Natl Acad Sci U S A. 2003;100:14211–6.PubMedCrossRef
37.
go back to reference Goodfriend TL, Ball DL, Egan BM, et al. Epoxy-keto derivative of linoleic acid stimulates aldosterone secretion. Hypertension. 2004;43:358–63.PubMedCrossRef Goodfriend TL, Ball DL, Egan BM, et al. Epoxy-keto derivative of linoleic acid stimulates aldosterone secretion. Hypertension. 2004;43:358–63.PubMedCrossRef
38.
go back to reference Fliser D, Schaefer F, Schmid D, et al. Angiotensin II affects basal, pulsatile, and glucose-stimulated insulin secretion in humans. Hypertension. 1997;30:1156–61.PubMedCrossRef Fliser D, Schaefer F, Schmid D, et al. Angiotensin II affects basal, pulsatile, and glucose-stimulated insulin secretion in humans. Hypertension. 1997;30:1156–61.PubMedCrossRef
39.
go back to reference Blanco S, Bonet J, Lopez D, et al. ACE inhibitors improve nephrin expression in Zucker rats with glomerulosclerosis. Kidney Int Suppl. 2005;93:S10–4.PubMedCrossRef Blanco S, Bonet J, Lopez D, et al. ACE inhibitors improve nephrin expression in Zucker rats with glomerulosclerosis. Kidney Int Suppl. 2005;93:S10–4.PubMedCrossRef
40.
go back to reference Saitoh Y, Hongwei W, Ueno H, et al. Telmisartan attenuates fatty-acid-induced oxidative stress and NAD(P)H oxidase activity in pancreatic beta-cells. Diabetes Metab. 2009;35:392–7.PubMedCrossRef Saitoh Y, Hongwei W, Ueno H, et al. Telmisartan attenuates fatty-acid-induced oxidative stress and NAD(P)H oxidase activity in pancreatic beta-cells. Diabetes Metab. 2009;35:392–7.PubMedCrossRef
41.
go back to reference • Habibi J, Hayden MR, Sowers JR, et al. Nebivolol attenuates redox-sensitive glomerular and tubular mediated proteinuria in obese rats. Endocrinology. 2011;152:659–68. This article describes a possible nonhemodynamic mechanism by which a non-specific beta blocker may inhibit proteinuria.PubMedCrossRef • Habibi J, Hayden MR, Sowers JR, et al. Nebivolol attenuates redox-sensitive glomerular and tubular mediated proteinuria in obese rats. Endocrinology. 2011;152:659–68. This article describes a possible nonhemodynamic mechanism by which a non-specific beta blocker may inhibit proteinuria.PubMedCrossRef
42.
go back to reference Ahima RS. Linking adiponectin to proteinuria. J Clin Invest. 2008;118(5):1619–22.PubMed Ahima RS. Linking adiponectin to proteinuria. J Clin Invest. 2008;118(5):1619–22.PubMed
Metadata
Title
Pathophysiology of Obesity-Related Renal Dysfunction Contributes to Diabetic Nephropathy
Authors
George Bayliss
Larry A. Weinrauch
John A. D’Elia
Publication date
01-08-2012
Publisher
Current Science Inc.
Published in
Current Diabetes Reports / Issue 4/2012
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-012-0288-1

Other articles of this Issue 4/2012

Current Diabetes Reports 4/2012 Go to the issue

Microvascular Complications—Retinopathy (JK Sun, Section Editor)

Novel Targets Against Retinal Angiogenesis in Diabetic Retinopathy

Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Glycemic Control in Diabetic Dialysis Patients and the Burnt-Out Diabetes Phenomenon

Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Anti-Fibrosis Therapy and Diabetic Nephropathy

Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Insights into the Genetic Architecture of Diabetic Nephropathy

Microvascular Complications—Neuropathy (D Ziegler, Section Editor)

Small Fiber Neuropathy: Is Skin Biopsy the Holy Grail?

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine