Obesity in CKD—What Should Nephrologists Know? : Journal of the American Society of Nephrology (original) (raw)
Up Front Matters
*Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden;
†National Research Council-Institute of Biomedicine and Nephrology, Dialysis and Transplantation Unit of Reggio Calabria, Reggio Calabria, Italy; and
‡Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee
Correspondence: Dr. Peter Stenvinkel, Department of Renal Medicine, K56, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Email: [email protected]
Abstract
Obesity, the epidemic of the 21st century, carries a markedly increased risk for comorbid complications, such as type 2 diabetes, cancer, hypertension, dyslipidemia, cardiovascular disease, and sleep apnea. In addition, obesity increases the risk for CKD and its progression to ESRD. Paradoxically, even morbid obesity associates with better outcomes in studies of ESRD patients on maintenance dialysis. Because the number of obese CKD and maintenance dialysis patients is projected to increase markedly in developed as well as low- and middle-income countries, obesity is a rapidly emerging problem for the international renal community. Targeting the obesity epidemic represents an unprecedented opportunity for health officials to ameliorate the current worldwide increase in CKD prevalence. Nephrologists need more information about assessing and managing obesity in the setting of CKD. Specifically, more precise estimation of regional fat distribution and the amount of muscle mass should be introduced into regular clinical practice to complement more commonly used practical markers, such as body mass index. Studies examining the effects of obesity on kidney disease progression and other clinical outcomes along with weight management strategies are much needed in this orphan area of research.
Copyright © 2013 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
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