Document Detail

Is obesity a major cause of chronic kidney disease?
MedLine Citation:
PMID:  14730537     Owner:  NLM     Status:  MEDLINE    
Excess weight gain is a major risk factor for essential hypertension and for end-stage renal disease (ESRD). Obesity raises blood pressure by increasing renal tubular sodium reabsorption, impairing pressure natriuresis, and causing volume expansion because of activation of the sympathetic nervous system and renin-angiotensin system and by physical compression of the kidneys, especially when visceral obesity is present. Obesity also causes renal vasodilation and glomerular hyperfiltration that initially serve as compensatory mechanisms to maintain sodium balance in the face of increased tubular reabsorption. In the long-term, however, these changes, along with the increased systemic arterial pressure, create a hemodynamic burden on the kidneys that causes glomerular injury. With prolonged obesity, there is increasing urinary protein excretion and gradual loss of nephron function that worsens with time and exacerbates hypertension. With the worsening of metabolic disturbances and the development of type II diabetes in some obese patients, kidney disease progresses much more rapidly. Weight reduction is an essential first step in the management of obesity, hypertension, and kidney disease. Special considerations for the obese patient, in addition to adequately controlling the blood pressure, include correction of the metabolic abnormalities and protection of the kidneys from further injury.
John E Hall; Jeffrey R Henegar; Terry M Dwyer; Jiankang Liu; Alexandre A Da Silva; Jay J Kuo; Lakshmi Tallam
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Advances in renal replacement therapy     Volume:  11     ISSN:  1073-4449     ISO Abbreviation:  Adv Ren Replace Ther     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-19     Completed Date:  2004-09-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9433799     Medline TA:  Adv Ren Replace Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-54     Citation Subset:  IM    
Department of Physiology and Biophysics and Center of Excellence in Cardiovascular-Renal Research, The University of Mississippi Medical Center, Jackson, MS, USA.
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MeSH Terms
Diabetes Mellitus / etiology,  physiopathology
Hypertension / etiology,  physiopathology
Kidney / metabolism,  physiopathology*
Kidney Failure, Chronic / etiology*,  metabolism*,  physiopathology,  prevention & control
Lipid Peroxidation
Obesity / complications*,  metabolism*,  physiopathology
Oxidative Stress
Renin-Angiotensin System
Risk Factors
Sympathetic Nervous System / physiopathology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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