Obesity Management and Chronic Kidney Disease

Chen, Yang; Dabbas, Walaa; Gangemi, Antonio; Benedetti, Enrico; Lash, James P.; Perkins, David L.

doi:10.1016/j.semnephrol.2021.06.010

Cited by 28 publications

(16 citation statements)

References 102 publications

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“…This may lead to early hazardous effects of obesity in these patients. Although our study did not evaluate biologic markers or follow-up data, previous studies have shown that the hazardous effects of obesity develop through various underlying mechanisms, such as aggravation of sarcopenia, or chronic inflammation 18 .…”

Section: Discussionmentioning

confidence: 99%

Association between low handgrip strength and obesity with mortality in peritoneal dialysis patients

Young

Kang

2023

Sci Rep

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The association between sarcopenia and obesity in peritoneal dialysis (PD) patients is more complex than that of the general population. The aim of this study was, therefore, to evaluate the association of patient survival with sarcopenia or sarcopenic components and obesity in groups of patients with PD. We retrospectively analyzed a dataset from 199 prevalent PD patients. Measurements including handgrip strength (HGS), appendicular lean mass index, and baseline characteristics, were obtained during the period of study. Patients were divided into four groups according to their HGS and obesity: NH-NO (normal HGS and non-obesity, n = 60), NH-O (normal HGS and obesity, n = 31), LH-NO (low HGS and non-obesity, n = 71), and LH-O (low HGS and obesity, n = 37). The median follow-up interval was 17 months. The Kaplan–Meier curve analysis showed that the LH-O group had the poorest patient survival outcome among the four groups (P < 0.001). The NH-NO group had a better patient survival outcome compared with the LH-NO group. Univariate and multivariate Cox regression analyses showed that the LH-O group had the highest mortality rate compared with the other groups. The NH-NO group had lower mortality compared with the LH-NO group. The present study demonstrated that obesity with low HGS was associated with the greatest mortality rate in groups defined by HGS and obesity.

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Section: Discussionmentioning

confidence: 99%

Association between low handgrip strength and obesity with mortality in peritoneal dialysis patients

Young

Kang

2023

Sci Rep

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“…Nutritional management of obesity consists of a reduced calorie diet, usually complemented with increased exercise, although this approach is yet to show long-term benefits in stopping CKD progression [ 72 ]. Most studies show that nutritional management is effective at reducing weight and controlling blood pressure and proteinuria, but long-term effects on eGFR have not been clarified; moreover, no substantial data exist supporting the superiority of a specific dietary pattern to promote weight loss in subjects with CKD [ 73 ].…”

Section: New Options For the Treatment Of Obesity-associated Ckdmentioning

confidence: 99%

Novel Insights in the Physiopathology and Management of Obesity-Related Kidney Disease

et al. 2022

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Obesity is recognized as an independent risk factor for the development of kidney disease, which has led to the designation of obesity-related glomerulopathy (ORG). Common renal features observed in this condition include glomerular hypertrophy, glomerulosclerosis, haemodynamic changes and glomerular filtration barrier defects. Additionally, and although less studied, obesity-related kidney disease also involves alterations in renal tubules, including tubule hypertrophy, lipid deposition and tubulointerstitial fibrosis. Although not completely understood, the harmful effects of obesity on the kidney may be mediated by different mechanisms, with alterations in adipose tissue probably playing an important role. An increase in visceral adipose tissue has classically been associated with the development of kidney damage, however, recent studies point to adipose tissue surrounding the kidney, and specifically to the fat within the renal sinus, as potentially involved in the development of ORG. In addition, new strategies for the treatment of patients with obesity-related kidney disease are focusing on the management of obesity. In this regard, some non-invasive options, such as glucagon-like peptide-1 (GLP-1) receptor agonists or sodium–glucose cotransporter-2 (SGLT2) inhibitors, are being considered for application in the clinic, not only for patients with diabetic kidney disease but as a novel pharmacological strategy for patients with ORG. In addition, bariatric surgery stands as one of the most effective options, not only for weight loss but also for the improvement of kidney outcomes in obese patients with chronic kidney disease.

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“…Conservative management of obesity primarily consists in reduced calorie diet and increased exercise, although this approach has failed to show a long-term benefit on halting CKD progression, with high rates of weight gain after rapid initial weight loss [6]. In most lifestyle intervention randomized controlled trials (RCTs), lifestyle modification was generally effective at reducing weight and lowering blood pressure and proteinuria, although follow-up was short and conclusions on long-term effects on eGFR could not be drawn.…”

Section: Therapeutic Options For Obese Patients With Ckdmentioning

confidence: 99%

Anything New in the Treatment of Obesity in Obese Patients with CKD?

Pérez

Garcia-Galán

Girbal

et al. 2022

Nephron

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Treatment for obesity in patients with CKD englobes a wide range of options, from lifestyle modification to bariatric surgery. Weight loss improves metabolic parameters and stimulates changes in renal function that lead to improvement of glomerular hyperfiltration. The most common clinical presentation is a slowly increasing non-nephrotic proteinuria that is followed by a progressive decline of kidney function. The use of multitarget therapies, with appropriate dietary education, emerging diets, the use of new RAAS blocking agents, the combination of iSGLT2 or GLP-1 agonists, as well as bariatric surgery, may play a key role in finally achieving the desired nephroprotection in this CKD population. New therapeutic agents and novel biomarkers, such as adipocyte cytokines, are needed to monitor and mitigate progression to end-stage renal disease. The emerging “lipidomics” and the role of nonalcoholic fatty liver are relevant research lines.

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Obesity Management and Chronic Kidney Disease

Cited by 28 publications

References 102 publications

Association between low handgrip strength and obesity with mortality in peritoneal dialysis patients

Association between low handgrip strength and obesity with mortality in peritoneal dialysis patients

Novel Insights in the Physiopathology and Management of Obesity-Related Kidney Disease

Anything New in the Treatment of Obesity in Obese Patients with CKD?

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