Pathophysiology of Obesity-Related Renal Dysfunction Contributes to Diabetic Nephropathy
- 1.5k Downloads
Recent studies have demonstrated the role of insulin resistance in renal injury related to obesity, with hyperfiltration leading to glomerulomegaly in a pattern similar to that found in diabetic nephropathy. Similarities in the histologic patterns of damage from obesity and diabetes point to overlapping mechanisms of injury. In this review, we will examine the hormonal mechanisms, signaling pathways and injury patterns in renal injury resulting from obesity and attempt to draw conclusions on the reasons for these similarities.
KeywordsObesity Obstructive sleep apnea Proteinuria Insulin resistance Podocyte Nephrin Adipocyte Diabetes Renal dysfunction Diabetic nephropathy
The authors wish to thank Diane Young for her help in preparing this article.
Conflicts of interest: G. Bayliss: none; L.A. Weinrauch: none; J.A. D’Elia: has received grant support from the Pat Covelli Foundation, Amgen Corp., and Bayer Laboratories as investigator-initiated research.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 16.Chagnac A, Weinstein T, Korzets A, et al. Glomerular hemodynamics in severe obesity. Am J Physiol Ren Physiol. 2000;278:F817–22.Google Scholar
- 31.• Fornoni A, Jeon J, Varona Santos J, et al. Nephrin is expressed on the surface of insulin vesicles and facilitates glucose-stimulated insulin releases. Diabetes. 2010;59:190–9. This article discusses the role of nephrin, an important glomerular protein, in secretion of insulin vessicles in the pancreas.PubMedCrossRefGoogle Scholar
- 41.• Habibi J, Hayden MR, Sowers JR, et al. Nebivolol attenuates redox-sensitive glomerular and tubular mediated proteinuria in obese rats. Endocrinology. 2011;152:659–68. This article describes a possible nonhemodynamic mechanism by which a non-specific beta blocker may inhibit proteinuria.PubMedCrossRefGoogle Scholar