Obesity and kidney disease: hidden consequences of the epidemic

Abstract

Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for chronic kidney disease (CKD). A high body mass index is one of the strongest risk factors for new-onset CKD. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing CKD in the long term. The incidence of obesity-related glomerulopathy has increased 10-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyles and health policy measures that make preventive behaviors an affordable option.

Keywords: chronic kidney disease; kidney cancer; nephrolithiasis; obesity; prevention.

Fig. 1

Putative mechanisms of action whereby obesity causes CKD. CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; HTN, hypertension; RAAS, renin-angiotensin-aldosterone system.

Fig. 2

Obesity-related perihilar focal segmental glomerulosclerosis on a background of glomerulomegaly. Periodic acid–Schiff stain, original magnification ×400. Courtesy of Dr Patrick D. Walker, MD (Arkana Laboratories, Little Rock, AR, USA).