Obesity, diabetes, and chronic kidney disease.
Obesity, diabetes, and chronic kidney disease.
复制标题
DOI：
10.1007/s11892-007-0076-5
复制
发表时间：
2007-12-01
影响因子：
4.2
通讯作者：
Eknoyan, Garabed
中科院分区：
文献类型：
--
作者：
Eknoyan, Garabed
与糖尿病相似，肥胖与早期肾小球肥大、高滤过肾血流动力学改变和蛋白尿增加有关，这些都可能随着体重减轻而逆转。然而，持续性肥胖实验模型中的局灶节段性肾小球硬化的病理损害，以及肥胖者出现大量蛋白尿的病理损害，与经典的糖尿病肾病不同。此外，一些观察性、横断性和纵向研究证明，肥胖是慢性肾脏疾病发病、加重病程和不良结局的独立危险因素，即使在调整了包括糖尿病和高血压在内的混杂合并症之后，糖尿病和高血压是慢性肾脏疾病的两个主要原因。
Similar to diabetes, obesity is associated with the early onset of glomerulomegaly, hemodynamic changes of a hyperfiltering kidney, and increased albuminuria, which are potentially reversible with weight loss. However, the pathologic lesions of focal segmental glomerulosclerosis in experimental models of sustained obesity, and in obese humans presenting with massive proteinuria, are different from those of classic diabetic nephropathy. In addition, several observational, cross-sectional, and longitudinal studies document obesity as an independent risk factor for the onset, aggravated course, and poor outcomes of chronic kidney disease, even after adjustment for confounding comorbidities, including diabetes and hypertension, the two major causes of chronic kidney disease.