Obesity is a risk factor for the development and progression of CKD, which has been shown in numerous studies. The mechanism of how this occurs is not completely understood, but several putative mechanisms proposed via adiposity, include low adiponectin high leptin and resistin, causing inflammation, insulin resistance, RAAS activation and oxidative stress, leading to CKD; in addition, it also causes diabetes mellitus, hypertension, and cardiovascular disease. Obesity is a persistent inflammatory state, and inflammation has been shown to play an important role in the development and progression of diabetic kidney disease, hence controlling obesity has become a key component as a preventative strategy in the development of kidney disease.
Kovesdy CP, Furth SL, Zoccali C. Obesity and Kidney Disease: Hidden Consequences of the Epidemic. Canadian Journal of Kidney Health and Disease. 2017; 4. https://doi.org/10.1177/2054358117698669
Rico-Fontalvo J, Aroca G, Cabrales J, Daza-Arnedo R, Yánez-Rodríguez T, Martínez-Ávila MC, et al. Molecular Mechanisms of Diabetic Kidney
Disease. Int. J. Mol. Sci. 2022;2: 8668. https://doi.org/10.3390/ijms23158668
Mottl A, Alicic R, Argyropoulos C, Brosius FC, Mauer M, Molitch M, et al. KDOQI US Commentary on the KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD. Am J Kidney Dis 2022;79(4):457-479. https://doi.org/10.1053/j.ajkd.2021.09.010
Van der Aart-van der Beek AB, Clegg LE, Penland RC, Boulton DW, Sjostrom CD Mentz RJ, et al. Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: a post hoc analysis of the EXSCEL trial. Diabetes Obes Metab 2020;22: https://doi.org/10.1111/dom.14175
Idzerda NMA, Clegg LE, Hernandez AF, Bakris G, Penland RC, Boulton DW, et al. Prediction and validation of exenatide risk marker effects on progression of renal disease: insights from EXSCEL. Diabetes Obes Metab 2020;22(5): 798-806. https://doi.org/10.1111/dom.13958
Gerstein HC, Sattar N, Rosenstock J, Ramasundarahettige C, Pratley R, Lopes RD, et al. AMPLITUDE-O Trials Investigator. Cardiovascular and renal outcomes with efpeglenatide in type 2 diabetes. N Engl J Med 2021;385(10):896-907. https://doi.org/10.1056/nejmoa2108269
Leoncini, G.; Russo, E.; Bussalino, E.; Barnini, C.; Viazzi, F.; Pontremoli, R. SGLT2is and Renal Protection: From Biological Mechanisms to Real-World Clinical Benefits. Int. J. Mol. Sci. 2021;22(9):4441. https://doi.org/10.3390/ijms22094441
Heerspink HJL, Stefánsson BV, Correa-Rotter R, Chertow GM, Greene T, Hou FF, et al. DAPA-CKD Trial Committees and Investigators. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2020 Oct 8;383(15):1436-1446. https://doi.org/10.1056/nejmoa2024816
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.