Obesity and chronic kidney disease: prevalence, mechanism, and management

Yim, Hyung Eun; Yoo, Kee Hwan

doi:10.3345/cep.2021.00108

Cited by 30 publications

(31 citation statements)

References 97 publications

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“…Children were eligible if they had obesity (BMI > 95th %ile) and were presenting for a well child visit. We selected young age and obesity as inclusion criteria, as childhood and adolescent obesity has been implicated to increase the risk of later developing CKD [ 30 , 31 , 32 ]. Exclusion criteria included a diagnosis of hypertension, diabetes, or known kidney or heart disease.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Human Urinary Exosomes Isolated via Ultracentrifugation Alone versus Ultracentrifugation Followed by SEC Column-Purification

Huang

Garimella

Clay-Gilmour

et al. 2022

JPM

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Chronic kidney disease is a progressive, incurable condition that involves a gradual loss of kidney function. While there are no non-invasive biomarkers available to determine whether individuals are susceptible to developing chronic kidney disease, small RNAs within urinary exosomes have recently emerged as a potential candidate to use for assessing renal function. Ultracentrifugation is the gold standard for urinary exosome isolation. However, extravesicular small RNA contamination can occur when isolating exosomes from biological fluids using ultracentrifugation, which may lead to misidentifying the presence of certain small RNA species in human urinary exosomes. Therefore, we characterized human urinary exosomal preparations isolated by ultracentrifugation alone, or via ultracentrifugation followed by size exclusion chromatography (SEC) column-purification. Using nanoparticle tracking analysis, we identified SEC fractions containing robust amounts of exosome-sized particles, that we further characterized using immunoblotting. When compared to exosomal preparations isolated by ultracentrifugation only, SEC fractionated exosomal preparations showed higher levels of the exosome-positive marker CD81. Moreover, while the exosome-negative marker calnexin was undetectable in SEC fractionated exosomal preparations, we did observe calnexin detection in the exosomal preparations isolated by ultracentrifugation alone, which implies contamination in these preparations. Lastly, we imaged SEC fractionated exosomal preparations using transmission electron microscopy to confirm these preparations contained human urinary exosomes. Our results indicate that combining ultracentrifugation and SEC column-purification exosome isolation strategies is a powerful approach for collecting contaminant-free human urinary exosomes and should be considered when exosomes devoid of contamination are needed for downstream applications.

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Section: Methodsmentioning

confidence: 99%

Comparison of Human Urinary Exosomes Isolated via Ultracentrifugation Alone versus Ultracentrifugation Followed by SEC Column-Purification

Huang

Garimella

Clay-Gilmour

et al. 2022

JPM

View full text Add to dashboard Cite

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“…Additionally, the production of inflammatory mediators, such as adipokines and cytokines, and profibrotic factors increase inflammation, endothelial dysfunction, and renal injury. Ultimately, obesity and CKD share a close association; however, the pathophysiology of obesity-related CKD is seemingly multifactorial (19).…”

Section: Effect Of Obesity On Chronic Kidney Disease and Its Progressionmentioning

confidence: 99%

“…Thanks to its endocrine functions, adipose tissue exerts a role in the production of several hormones, cytokines, and chemokines collectively named adipokines. Adipokines are involved in a multitude of processes such as lipid metabolism, insulin resistance, inflammation, atherosclerosis, and extracellular matrix deposition (19). Over and above the widely known mediators TNF-α, IL-6, and MCP-1, the most studied adipokines include leptin and adiponectin.…”

Section: Adipokinesmentioning

confidence: 99%

Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management

et al. 2022

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Obesity is the epidemic of our era and its incidence is supposed to increase by more than 30% by 2030. It is commonly defined as a chronic and metabolic disease with an excessive accumulation of body fat in relation to fat-free mass, both in terms of quantity and distribution at specific points on the body. The effects of obesity have an important impact on different clinical areas, particularly endocrinology, cardiology, and nephrology. Indeed, increased rates of obesity have been associated with increased risk of cardiovascular disease (CVD), cancer, type 2 diabetes (T2D), dyslipidemia, hypertension, renal diseases, and neurocognitive impairment. Obesity-related chronic kidney disease (CKD) has been ascribed to intrarenal fat accumulation along the proximal tubule, glomeruli, renal sinus, and around the kidney capsule, and to hemodynamic changes with hyperfiltration, albuminuria, and impaired glomerular filtration rate. In addition, hypertension, dyslipidemia, and diabetes, which arise as a consequence of overweight, contribute to amplifying renal dysfunction in both the native and transplanted kidney. Overall, several mechanisms are closely related to the onset and progression of CKD in the general population, including changes in renal hemodynamics, neurohumoral pathways, renal adiposity, local and systemic inflammation, dysbiosis of microbiota, insulin resistance, and fibrotic process. Unfortunately, there are no clinical practice guidelines for the management of patients with obesity-related CKD. Therefore, dietary management is based on the clinical practice guidelines for the nutritional care of adults with CKD, developed and published by the National Kidney Foundation, Kidney Disease Outcome Quality Initiative and common recommendations for the healthy population. Optimal nutritional management of these patients should follow the guidelines of the Mediterranean diet, which is known to be associated with a lower incidence of CVD and beneficial effects on chronic diseases such as diabetes, obesity, and cognitive health. Mediterranean-style diets are often unsuccessful in promoting efficient weight loss, especially in patients with altered glucose metabolism. For this purpose, this review also discusses the use of non-classical weight loss approaches in CKD, including intermittent fasting and ketogenic diet to contrast the onset and progression of obesity-related CKD.

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“…The Moscow Children's hypertension study showed hyperuricemia (>8.0 mg/dL) in only 9.5% of children with normal blood pressure but as many as 49% in children with borderline hypertension and up to 73% of children with moderate or severe hypertension. 7) In a recent issue of Clinical and Experimental Pediatrics, Yim et al 8) reviewed the epidemiology of childhood obesity, the mechanism of obesity in kidney disease, and the management of obesity leading to chronic kidney disease (CKD). The authors emphasized the correlation between maternal obesity and offspring CKD, the effects and mechanisms of obesity on renal dysfunction, and prevention methods.…”

mentioning

confidence: 99%

“…In a recent issue of Clinical and Experimental Pediatrics , Yim and Yoo [ 8 ] reviewed the epidemiology of childhood obesity, the mechanism of obesity in kidney disease, and the management of obesity leading to chronic kidney disease (CKD). The authors emphasized the correlation between maternal obesity and offspring CKD, the effects and mechanisms of obesity on renal dysfunction, and prevention methods.…”

mentioning

confidence: 99%