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Obesity and the Kidney

Editor(s): Wolf G. (Jena) 
Cover

Obesity and Renal Hemodynamics

Bosma R. · Krikken J. · Homan van der Heide J. · de Jong P. · Navis G.

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Department of Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, The Netherlands

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Wolf G (ed): Obesity and the Kidney. Contrib Nephrol. Basel, Karger, 2006, vol 151, pp 184-202

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: August 21, 2006
Cover Date: 2006

Number of Print Pages: 19
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-8164-6 (Print)
eISBN: 978-3-318-01384-9 (Online)

Abstract

Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile independent of these factors, and that may exert effects on renal damage as well. In animal models of obesity-associated renal damage, micro-puncture studies showed glomerular hypertension and hyperfiltration. In humans an elevated glomerular filtration rate has been demonstrated in several studies, sometimes associated with hyperperfusion as well, independent of blood pressure or the presence of diabetes. An elevated filtration fraction was found in several studies, consistent with glomerular hypertension. This renal hemodynamic profile resembles the hyperfiltration pattern in diabetes and is therefore assumed to be a pathogenetic factor in renal damage. Of note, the association between body mass index and renal hemodynamics is not limited to overt obesity or overweight, but is also present across the normal range, without a particular threshold. Multiple factors are assumed to contribute to these renal hemodynamic alterations, such as insulin resistance, the renin-angiotensin system and the tubulo-glomerular responses to increased proximal sodium reabsorption, and possibly also inappropriate activity of the sympathetic nervous system and increased leptin levels. Obesity has a high world-wide prevalence. On a population-basis, therefore, its contribution to long-term renal risk may be considerable, especially as it is usually clustered with risk factors like hypertension and insulinresistance. In short-term studies the renal hemodynamic alterations in obesity and the associated proteinuria were reversible by weight loss, and renin-angiotensin system-blockade, respectively. These interventions are therefore likely to have the potential to limit the renal risks of obesity.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: August 21, 2006
Cover Date: 2006

Number of Print Pages: 19
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-8164-6 (Print)
eISBN: 978-3-318-01384-9 (Online)


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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