Obesity and chronic kidney disease
Obesity and chronic kidney disease
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DOI：
10.3265/nefrologia.pre2011.may.10963
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发表时间：
2011-01-01
期刊：
影响因子：
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通讯作者：
Eknoyan, G.
中科院分区：
文献类型：
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作者：
Eknoyan, G.
肥胖与早期发生肾小球肥大、高滤过性肾脏血流动力学改变和蛋白尿增加有关，这些都有可能随着体重减轻而逆转。然而，局灶节段性肾小球硬化的病理损害发生在持续性肥胖的实验模型中，并在出现大量蛋白尿的病态肥胖者中观察到。此外，几项观察性、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，即使在调整了包括代谢综合征、糖尿病和高血压在内的混杂并发症后也是如此，代谢综合征、糖尿病和高血压是慢性肾脏疾病的主要原因。在超重和肥胖的慢性肾脏病(CKD)患者的治疗中，应考虑早期饮食干预以减轻体重，并在必要时进行减肥手术。
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, pathologic lesions of focal segmental glomerulosclerosis develop in experimental models of sustained obesity, and are observed in morbidly obese humans presenting with massive proteinuria. In addition, several observational, cross sectional and longitudinal studies document that obesity is as an independent risk factor for the onset, aggravated course, and poor outcomes of chronic kidney disease, even after adjustment for confounding comorbidities including metabolic syndrome, diabetes and hypertension, the major causes of chronic kidney disease. Early dietary intervention to reduce weight, and where necessary bariatric surgery, should be considered in the management of overweight and obese chronic kidney disease (CKD) patients.