Pathological influence of obesity on renal structural changes in chronic kidney disease

Kato, Shota; Nazneen, Arifa; Nakashima, Yumiko; Razzaque, Mohammed S.; Nishino, Tomoya; Furusu, Akira; Yorioka, Noriaki; Taguchi, Takashi

doi:10.1007/s10157-009-0169-3

Cited by 47 publications

(33 citation statements)

References 23 publications

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“…Renal biopsy samples showing any clinical and histologic evidence of other primary or secondary renal diseases, including diabetic nephropathy, were carefully eliminated. The appearance of an increased glomerular basement membrane thickness alone was not a criterion for exclusion because studies have suggested that obese patients or those with ORG can have an increased glomerular basement membrane thickness in the absence of diabetes (18,19). Hypertension was not an exclusion criterion.…”

Section: Patient Selectionmentioning

confidence: 99%

Low Glomerular Density with Glomerulomegaly in Obesity-Related Glomerulopathy

Tsuboi

Utsunomiya

Kanzaki

et al. 2012

Clinical Journal of the American Society of Nephrology

106

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SummaryBackground and objectives Obesity-related glomerulopathy is a secondary form of glomerular disease that may occur in obese individuals. It is histologically characterized by marked glomerulomegaly closely related to glomerular hyperfiltration. This study examined glomerular density (nonsclerotic glomerular number per renal cortical area of biopsy specimen) in patients with obesity-related glomerulopathy to determine whether any differences in this measure is associated with disease status.Design, setting, participants, & measurements Glomerular density and glomerular volume in renal biopsy samples from patients with obesity-related glomerulopathy were compared with those of kidney transplant donors and patients with IgA nephropathy. Kidneys obtained from persons without renal diseases during autopsy were also analyzed to investigate the effects of obesity on glomerular density and glomerular volume.Results Glomerular density of kidneys from patients with obesity-related glomerulopathy (1.760.6/mm 2 ) was significantly lower than that in biopsy samples from kidney transplant donors (3.161.0/mm 2 ) and patients with IgA nephropathy (3.561.5/mm 2 ). However, an analysis of autopsy cases without renal diseases showed that the glomerular density in overweight (2.960.7/mm 2 ) or obese (3.161.1/mm 2 ) persons was similar to that in nonobese (3.160.6/mm 2 ) individuals. Biopsy specimens of patients with obesity-related glomerulopathy showed marked glomerulomegaly. However, glomerular volume was only modestly increased in the autopsy-examined kidneys from overweight or obese persons without renal diseases.Conclusions Low glomerular density associated with glomerulomegaly may be a characteristic histologic finding of patients with obesity-related glomerulopathy.

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Section: Patient Selectionmentioning

confidence: 99%

Low Glomerular Density with Glomerulomegaly in Obesity-Related Glomerulopathy

Tsuboi

Utsunomiya

Kanzaki

et al. 2012

Clinical Journal of the American Society of Nephrology

106

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“…A case control study comparing renal biopsies in 95 morbidly obese patients undergoing bariatric surgery with 40 control subjects identified an independent relationship between BMI and likelihood of glomerular lesions (podocyte hypertrophy, increased mesangial cellularity or increased extracellular matrix) (89). Other investigators have found obesity to be associated with glomerular hypertrophy, basement membrane thickening, and overt proteinuria (90,91).…”

Section: Conventional Ckd Risk Factors and Osamentioning

confidence: 99%

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

Gildeh¹,

Drakatos²,

Higgins³

et al. 2016

J. Thorac. Dis.

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Obstructive sleep apnea (OSA) causes daytime fatigue and sleepiness, and has an established relationship with cardiovascular and metabolic disease. Recent years have seen the emergence of an evidence base linking OSA with an increased risk of degenerative neurological disease and associated cognitive impairment, an accelerated rate of decline in kidney function with an increased risk of clinically significant chronic kidney disease (CKD), and with a significantly higher rate of cancer incidence and death. This review evaluates the evidence base linking OSA with these seemingly unrelated co-morbidities, and explores potential mechanistic links underpinning their development in patients with OSA, including intermittent hypoxia (IH), sleep fragmentation, sympathetic excitation, and immune dysregulation.

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“…Esto ha sido documentado en el caso de la nefropatía por IgA en donde un IMC > 25 kg/m 2 es un buen predictor de aumento de la creatininemia 47 . En otras enfermedades como la nefroesclerosis benigna y la enfermedad de membrana basal delgada, la obesidad incrementa la proteinuria y se asocia a glomerulomegalia y engrosamiento de la membrana basal glomerular, hallazgos similares a los encontrados en la nefropatía relacionada a obesidad 48 .…”

Section: Manifestaciones Y Efecto Clínico De La Obesidad En La Evolucunclassified

Obesidad y enfermedad renal crónica: Una peligrosa asociación

Navarro

Ardiles

2015

Rev. méd. Chile

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L a enfermedad renal crónica (ERC) es un problema creciente a nivel mundial con una prevalencia estimada cercana a 10% 1 y la mayoría de las personas que están en fases tempranas no tienen conocimiento de su existencia, pudiendo evolucionar a la insuficiencia renal terminal si es que no media algún tipo de intervención.En nuestro país la prevalencia de ERC, incluyendo todas sus etapas, no es bien conocida. La Encuesta nacional de Salud encontró en el año 2010 una prevalencia de ERC con velocidad de filtración glomerular (VFG) menor a 60 ml/min/1,73 m 2 de 2,7% en población adulta presuntamente sana 2 . Por otra parte, en pacientes consultantes en la atención primaria de salud, la prevalencia global de ERC es de 12,1%, siendo significativamente superior en mujeres (14,5%) que en hombres (7,4%), encontrándose 11% de las personas en etapa 3, 0,3% en etapa 4 y 0,2% en etapa 5 3 . Los factores de riesgo clásicos que predisponen a desarrollar una ERC son la hipertensión arterial (HTA), diabetes mellitus (DM), edad superior a 60 años, presencia de enfermedad cardiovascular y la existencia de familiares en diálisis o sometidos a un trasplante renal 4 . Otros factores de riesgo descritos son el síndrome metabólico, tabaquismo, dislipidemia, sedentarismo y, el que nos interesa en este documento, la obesidad.La obesidad es también un problema actual de salud pública en muchos países y tiene una tendencia creciente, generando altos costos socioeconómicos y una disminución en la esperanza de vida estimándose que a nivel mundial en el año 2015 existirán más de 700 millones de personas obesas 5 . En nuestro país también existe una prevalencia expansiva y actualmente existen unos 4 millones de personas obesas, mayoritariamente mujeres, de edad avanzada y menor escolaridad 2 . Relación entre obesidad y enfermedad renal crónicaAunque existen escasos estudios que analizan la relación entre obesidad y riesgo de enfermedad renal crónica 6 , éstos han logrado demostrar que los pacientes obesos tienen más frecuentemente glomerulomegalia y glomeruloesclerosis focal y segmentaria 7 . También se ha observado que la obesidad se asocia a una mayor velocidad de pérdida de función renal en pacientes sometidos previamente a uninefrectomía o en quienes son

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Pathological influence of obesity on renal structural changes in chronic kidney disease

Abstract: Background: Role of obesity on renal pathological and structural changes is not

Cited by 47 publications

References 23 publications

Low Glomerular Density with Glomerulomegaly in Obesity-Related Glomerulopathy

Low Glomerular Density with Glomerulomegaly in Obesity-Related Glomerulopathy

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

Obesidad y enfermedad renal crónica: Una peligrosa asociación

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