Glomerulopathy Associated With Moderate Obesity

Abstract

IntroductionObesity-related glomerulopathy is an established secondary glomerular disease that may occur in obese individuals with a body mass index (BMI) of ≥30 kg/m2. However, patients with moderate obesity (BMI ≤ 30 kg/m2) may also develop this disease.MethodsA total of 20 patients with grade 1 obesity (25 ≤ BMI < 30 kg/m2) with persistent proteinuria, without evidence of other renal diseases, were analyzed retrospectively. These patients were compared with 20 patients with grade 2 or higher obesity (BMI ≥ 30 kg/m2) with persistent proteinuria. Biopsies of 31 kidney transplant donors as healthy controls were used to compare histologic parameters.ResultsSimilar to the grade 2 or higher obesity group, the grade 1 obesity group had a male predominance (85%) and showed a high incidence of hypertension (80%). Urinary protein excretion and renal outcome parameters were comparable between the groups. Patients with grade 1 obesity showed typical histologic features of obesity-related glomerulopathy: low glomerular density with glomerulomegaly. The glomerular density and mean glomerular volume in the grade 1 group, the grade 2 or higher group, and the kidney transplant donors with grade 1 obesity were 1.6 ± 0.8 versus 1.4 ± 0.6 versus 3.0 ± 1.1 (per mm2) and 6.1 ± 2.1 versus 6.4 ± 1.6 versus 2.9 ± 0.8 (×106 μm3), respectively.DiscussionA glomerulopathy similar to obesity-related glomerulopathy can occur in moderately obese individuals. Renal factor(s), such as low glomerular density, may thus underlie susceptibility to this disease entity as well as BMI.

Anaemia is an essential complication of ANCA-associated renal vasculitis: a single center cohort study

“…An expert renal pathologist made the diagnoses according to the international histological classification [ 18 ]. The area of tubulointerstitial damage was semi-quantitatively evaluated in renal cortical tissue [ 19 – 21 ].…”

The Renal Pathology of Obesity

“…Studies have shown that, among patients with even a moderate degree of obesity (BMI values < 30 kg/m 2 ), a subgroup exists that demonstrates the clinical and histopathological characteristics of typical ORG. 8 , 63 …”

Clinicopathological Implications of Proteinuria after Long-Term Isolated Hematuria due to Thin Basement Membrane Nephropathy and Focal Segmental Glomerulosclerosis

“…We further examined possible additional lesions consistent with obesity-related glomerulopathy (ORG). e glomerular density (the number of nonsclerotic glomeruli per renal cortical area) measured using an image analysis program (Aperio ImageScope, Leica, Bu alo Grove, IL, USA) was 1.7 mm 2 , which was low compared with that in nonobese kidney donors and comparable to the reported glomerular density in patients with ORG [9]. GBM width of the nonsclerotic area of the glomerulus with perihilar sclerosis was expected to be thick or normal in ORG [10], however, electron microscopic specimen including the glomerulus was not obtained.…”