| Is obesity a major cause of chronic kidney disease? | |
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MedLine Citation:
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PMID: 14730537 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Advances in renal replacement therapy Volume: 11 ISSN: 1073-4449 ISO Abbreviation: Adv Ren Replace Ther Publication Date: 2004 Jan |
Date Detail:
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Created Date: 2004-01-19 Completed Date: 2004-09-23 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9433799 Medline TA: Adv Ren Replace Ther Country: United States |
Other Details:
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Languages: eng Pagination: 41-54 Citation Subset: IM |
Affiliation:
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Department of Physiology and Biophysics and Center of Excellence in Cardiovascular-Renal Research, The University of Mississippi Medical Center, Jackson, MS, USA. jehall@physiology.umsmed.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Diabetes Mellitus
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etiology,
physiopathology Humans 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 | |
ID/Acronym/Agency:
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P01 HL 51971/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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