The Case for a Bariatric-Centered Approach to CKD Care

Friedman, Allon N.

doi:10.2215/cjn.12061018

Cited by 3 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, these changes were accompanied with considerable improvement in blood pressure, inflammatory and metabolic markers, and these beneficial changes persisted for 1–5 years after surgery ( 124 ). Several clinical case reports indicate a considerable amelioration of proteinuria and obesity-induced nephropathy following bariatric surgery ( 125 , 126 ). However, bariatric surgery was accompanied with other unfavorable renal complications, such as nephrolithiasis, oxalate nephropathy and acute kidney injury ( 127 ).…”

Section: Treatment Of Obesity Induced Nephropathy and Possible Therapeutic Targetsmentioning

confidence: 99%

New Pandemic: Obesity and Associated Nephropathy

et al. 2021

View full text Add to dashboard Cite

Incidence of obesity related renal disorders have increased 10-folds in recent years. One of the consequences of obesity is an increased glomerular filtration rate (GFR) that leads to the enlargement of the renal glomerulus, i.e., glomerulomegaly. This heightened hyper-filtration in the setting of type 2 diabetes irreparably damages the kidney and leads to progression of end stage renal disease (ESRD). The patients suffering from type 2 diabetes have progressive proteinuria, and eventually one third of them develop chronic kidney disease (CKD) and ESRD. For ameliorating the progression of CKD, inhibitors of renin angiotensin aldosterone system (RAAS) seemed to be effective, but on a short-term basis only. Long term and stable treatment strategies like weight loss via restricted or hypo-caloric diet or bariatric surgery have yielded better promising results in terms of amelioration of proteinuria and maintenance of normal GFR. Body mass index (BMI) is considered as a traditional marker for the onset of obesity, but apparently, it is not a reliable indicator, and thus there is a need for more precise evaluation of regional fat distribution and amount of muscle mass. With respect to the pathogenesis, recent investigations have suggested perturbation in fatty acid and cholesterol metabolism as the critical mediators in ectopic renal lipid accumulation associated with inflammation, increased generation of ROS, RAAS activation and consequential tubulo-interstitial injury. This review summarizes the renewed approaches for the obesity assessment and evaluation of the pathogenesis of CKD, altered renal hemodynamics and potential therapeutic targets.

show abstract

Section: Treatment Of Obesity Induced Nephropathy and Possible Therapeutic Targetsmentioning

confidence: 99%

New Pandemic: Obesity and Associated Nephropathy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…119,126,127 It has been shown that bariatric surgery is accompanied not only by a significant reduction in proteinuria, but also by significant changes in the reduction of hypertension and inflammatory factors, especially 1-5 years after surgery. 128 Recently, endoscopic bariatric therapies have been rapidly developed to reduce gastric volume and delay gastric emptying, mainly through intragastric balloon placement, 129 sleeve gastroplasty, and aspiration therapy. 130 Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors…”

mentioning

confidence: 99%

The New Challenge of Obesity - Obesity-Associated Nephropathy

Hao,

Lv,

Liu

et al. 2024

DMSO

View full text Add to dashboard Cite

In recent years, obesity has become one of the major diseases that affect human health and consume human health resources, especially when it causes comorbidities such as hypertension, diabetes, cardiovascular disease and kidney disease. Many studies have demonstrated that obesity is associated with the development of chronic kidney disease and can exacerbate the progression of end-stage renal disease. This review described the mechanisms associated with the development of obesityassociated nephropathy and the current relevant therapeutic modalities, with the aim of finding new therapeutic targets for obesityassociated nephropathy. The mechanisms of obesity-induced renal injury include, in addition to the traditional alterations in renal hemodynamics, the involvement of various mechanisms such as macrophage infiltration in adipose tissue, alterations in adipokines (leptin and adiponectin), and ectopic deposition of lipids. At present, there is no "point-to-point" treatment for obesity-induced kidney injury. The renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-dependent glucose transporter 2 (SGLT-2) inhibitors and bariatric surgery described in this review can reduce urinary protein to varying degrees and delay the progression of kidney disease. In addition, recent studies on the therapeutic effects of intestinal flora on obesity may reduce the incidence of obesity-related kidney disease from the perspective of primary prevention. Both of these interventions have their own advantages and disadvantages, so the continuous search for the mechanism of obesity-induced related kidney disease will be extremely helpful for the future treatment of obesity-related kidney disease.

show abstract

<p>Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus</p>

Hu¹,

Zhang²

2020

IJGM

View full text Add to dashboard Cite

The purpose of this study was to identify diabetic nephropathy risk factors in type 2 diabetes mellitus obese people based on community type 2 diabetes mellitus patients. Patients and Methods: In the community in Shanghai, we conduct a questionnaire, physical examination, and biochemical examination. The 406 patients included in the analysis were divided into two groups based on whether or not they had diabetic nephropathy. The influencing factors of type 2 diabetes mellitus obese patients were screened by the least absolute shrinkage and selection operator method, and then the influencing factors detected by the least absolute shrinkage and selection operator method were included in the binary logistic regression analysis, and the risk factors for diabetic nephropathy in obese people with type 2 diabetes mellitus were obtained. Finally, the nomogram and forest plot are used to visualize the binary logistic regression results, and the calibration plot and receiveroperating characteristic curve are used to verify the result. Results: The results showed that family history of diabetes (OR= 2.091, P= 0.002), disease course (OR=1.050, P= 0.007). hypertension (OR=1.768, P=0.042), hyperuricemia (OR=2.263, P=0.003), systolic blood pressure (OR=1.027, P<0.001), and glycosylated haemoglobin A1c (OR=1.358, P<0.001) were risk factors for diabetic nephropathy. Conclusion: For obese patients with type 2 diabetes mellitus, they should pay attention to family history of diabetes, disease course and hyperuricemia. Hypertension should be concerned and strictly controlled. Systolic blood pressure and glycosylated haemoglobin A1c will help prolong the survival of diabetic nephropathy patients.

show abstract

The Case for a Bariatric-Centered Approach to CKD Care

Cited by 3 publications

References 10 publications

New Pandemic: Obesity and Associated Nephropathy

New Pandemic: Obesity and Associated Nephropathy

The New Challenge of Obesity - Obesity-Associated Nephropathy

<p>Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus</p>

Contact Info

Product

Resources

About