Early histological changes in the kidney of people with morbid obesity

Γούμενος, Δ.; Kawar, Bisher; Nahas, Meguid El; Conti, Sara; Wagner, Bettina; Spyropolous, C; Vlachojannis, John G.; Benigni, Ariela; Kalfarentzos, Fotis

doi:10.14341/2071-8713-5290

Cited by 16 publications

(22 citation statements)

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“…With increased single glomerulus filtration there is compensatory glomerulomegaly, [1][2][3][4][5] and the sum expected effect would be an increase in GFR. Obesity has been associated with glomerulomegaly 24,28,29 and with risk of CKD. 30,31 Hyperuricemia is also a risk factor for CKD, 32,33 and raising uric acid levels in rats leads to intraglomerular hypertension 34 and glomerular hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Association of Kidney Function and Metabolic Risk Factors With Density of Glomeruli on Renal Biopsy Samples From Living Donors

Rule

Semret

Amer

et al. 2011

Mayo Clinic Proceedings

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Section: Discussionmentioning

confidence: 99%

Association of Kidney Function and Metabolic Risk Factors With Density of Glomeruli on Renal Biopsy Samples From Living Donors

Rule

Semret

Amer

et al. 2011

Mayo Clinic Proceedings

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“…Metabolic risk factors such as obesity and hyperuricemia have been linked to CKD (31)(32)(33)(34)(35). Obesity has been associated with both glomerulomegaly (36,37) and lower profile glomerular density (38). Artificially increasing uric acid levels in animal models results in glomerular hypertrophy (39).…”

Section: Discussionmentioning

confidence: 99%

Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Elsherbiny

Alexander²,

Kremers³

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephrosclerosis had similar or different associations with kidney function and risk factors.Design, setting, participants, & measurements From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean nonsclerotic glomerular volume and glomerular density (globally sclerotic and nonsclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm 2 of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower nonsclerotic glomerular density. Nephrosclerosis was identified by higher globally sclerotic glomerular density.Results The mean (6SD) age was 44612 years, 24-hour urine albumin excretion was 567 mg, measured GFR was 103617 ml/min per 1.73 m 2 , uric acid was 5.261.4 mg/dl, and body mass index was 2865 kg/m 2 . Of the study participants, 43% were men, 11% had hypertension, and 52% had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower nonsclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density.Conclusions Nephron hypertrophy and nephrosclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.

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“…15 Histopathologic changes of obesity-related glomerulopathy were noted in obese patients with no evidence of renal disease. 16 Successful weight loss in patients with obesity-related kidney disease was associated with a reduction in glomerular hyperfiltration and albuminuria. 17,18 In our study, obesity was a predictor of future CKD up to 30 years before diagnosis.…”

Section: Potential Mechanismsmentioning

confidence: 99%

Mid-Adulthood Risk Factor Profiles for CKD

McMahon

Preis

Hwang

et al. 2014

Journal of the American Society of Nephrology

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Early identification of CKD risk factors may allow risk factor modification and prevention of CKD progression. We investigated the hypothesis that risk factors are present $30 years before the diagnosis of CKD in a case-control study using data from the Framingham Offspring Study. Patients with incident CKD (eGFR#60 ml/min per 1.73 m 2 ) at examination cycles 6, 7, and 8 were age-and sex-matched 1:2 to patients without CKD at baseline (examination 5). CKD risk factors were measured at each examination cycle. Logistic regression models, adjusted for age, sex, and time period, were constructed to compare risk factor profiles at each time point between cases and controls. During follow-up, 441 new cases of CKD were identified and matched to 882 controls (mean age 69.2 years, 52.4% women). Those who ultimately developed CKD were more likely to have hypertension (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.23 to 2.51), obesity (OR, 1.71; 95% CI, 1.14 to 2.59), and higher triglyceride levels (OR, 1.43; 95% CI, 1.12 to 1.83) 30 years before CKD diagnosis, and were more likely to have hypertension (OR, 1.38; 95% CI, 1.07 to 1.79), higher triglyceride levels (OR, 1.35; 95% CI, 1.11 to 1.64), lower HDL c (OR, 0.89; 95% CI, 0.81 to 0.97), and diabetes (OR, 2.90; 95% CI, 1.59 to 5.29) 20 years before CKD diagnosis. These findings demonstrate that risk factors for CKD are identifiable $30 years before diagnosis and suggest the importance of early risk factor identification in patients at risk for CKD.

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Early histological changes in the kidney of people with morbid obesity

Cited by 16 publications

References 0 publications

Association of Kidney Function and Metabolic Risk Factors With Density of Glomeruli on Renal Biopsy Samples From Living Donors

Association of Kidney Function and Metabolic Risk Factors With Density of Glomeruli on Renal Biopsy Samples From Living Donors

Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Mid-Adulthood Risk Factor Profiles for CKD

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