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Renal Disease in Obesity, Metabolic Syndrome and Diabesity

  • Esteban Porrini
  • Maruja Navarro-Díaz
  • Rosa Rodríguez-Rodríguez
  • Eduardo Salido
Chapter

Abstract

The pandemic of metabolic syndrome (MS), obesity, and type 2 diabetes – diabesity – may portend severe consequences in renal disease. In patients with obesity and particularly in extreme obesity, obesity-related glomerulopathy (ORG) is the classical picture of renal damage. ORG is characterized by glomerulomegaly and a secondary form of focal and segmental glomerulosclerosis. Interestingly, 50% of the cases with ORG also have “diabetoid changes” including mesangial expansion mainly in the absence of overt diabetes. This clearly indicates a common link between obesity and diabetes in the pathogenesis of renal disease. On the other hand, little evidence is available regarding pathogenesis, clinical evolution, and renal histology of renal disease in overweight and MS. In this chapter we will review the available evidence on renal disease in extreme obesity, moderate obesity overweight and MS. Major factors involved in renal disease in diabesity include hemodynamic changes leading to glomerular hyperfiltration, inflammation and lipotoxicity.

Keywords

Renal disease Obesity Metabolic syndrome Obesity-related glomerulopathy 

Notes

Acknowledgments

E.P. is a researcher of the Program Ramón y Cajal (RYC-2014-16573). We thank the Instituto de Salud Carlos III for the following grants, PI13/00342 and PI16/01814, and REDINREN RD16/0009/0031 and the IMBRAIN project for support (FP7-RE6-POT-2012-CT2012-31637-IMBRAIN). M.N.D is a researcher of the REMAR group (Recerca en Malalties d’Afectació Renal research on kidney diseases) 2017-SGR-301. We thank the Instituto de Salud Carlos III for the REDINREN RD16/0009/0032. The authors also thank the DIABESITY working group of the ERA-EDTA.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Esteban Porrini
    • 1
  • Maruja Navarro-Díaz
    • 2
    • 3
    • 4
  • Rosa Rodríguez-Rodríguez
    • 5
  • Eduardo Salido
    • 1
    • 5
  1. 1.University of La Laguna, ITB (Instituto de Tecnología Biomédicas), Hospital Universitario de Canarias, Nephrology UnitTenerifeSpain
  2. 2.Nephrology DepartmentGermans Trias i Pujol University HospitalBadalonaSpain
  3. 3.REMAR Group, Health Science Research Institute Germans Trias i Pujol, Can Ruti CampusBadalonaSpain
  4. 4.Autonomous University of BarcelonaBellaterraSpain
  5. 5.University of La Laguna, Pathology DepartmentHospital Universitario de CanariasTenerifeSpain

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