The sharp rise in the prevalence of chronic kidney disease (CKD) that parallels an increase in the prevalence of obesity in the recent years is a cause for great concern. CKD increases the rate of cardiovascular disease (CVD), development of end-stage renal disease, and leads to premature death. Although no direct causality link between obesity and CKD can yet be established, this appears highly likely. CKD should be regarded as a major complication of overweight and obesity, regardless of whether the association was independent or through the influence of diabetes, hypertension, CVD, metabolic syndrome and high fructose intake. We review the literature on the complex but positive association between obesity and CKD, the pathological effect of excess adiposity in kidney injury and the potential role of weight reduction therapy in reducing the burden of CKD.

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Cracking continues to be the number one concern about bridge deck construction. Rarely is a deck without cracks constructed. Transverse cracking mainly attributable to drying shrinkage is common in bridge decks and has been observed in many bridge decks newly constructed by the Virginia Department of Transportation (DOT). Shrinkage-reducing admixtures (SRAs) in concrete reduce shrinkage and are one of the most effective ways of reducing shrinkage cracking. A low modulus of elasticity and high creep also help minimize cracking. Lightweight concrete (LWC) has a lower modulus of elasticity, higher inelastic strains, a lower coefficient of thermal expansion, a more continuous contact zone between the aggregate and the paste, and more water in the pores of aggregates for continued internal curing than normal weight concrete: all these factors help reduce cracking in LWC. Drying shrinkage can also be counteracted with the use of shrinkage-compensating concrete (SC). When properly restrained by reinforcement, SC can expand an amount equal to or slightly greater than the anticipated drying shrinkage. The research in this paper investigated the effectiveness of SC, LWC, and concrete with SRA in reducing cracks in bridge decks and to develop a low-cracking bridge deck specification for use in future Virginia DOT bridge decks. The study showed that bridges with fewer and narrower cracks could be constructed with SRA, LWC, and SC and that proper construction practices were needed to reduce bridge deck cracking. This study resulted in the Virginia DOT implementing a low-cracking bridge deck specification.

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