Ahmed Mohamed H
Expert Opin Emerg Drugs. 2006 Nov;11(4):563-5. doi: 10.1517/14728214.11.4.563.
Obesity and being overweight are risk factors for kidney diseases. The spectrum ranges from glomerulomegaly with or without focal or segmental glomerulosclerosis, to diabetic nephropathy, to carcinoma of the kidney and nephrolithiasis. The first sign of renal injury is microalbuminuria or frank proteinuria, in particular in the presence of hypertension. The occurrence of microalbuminuria and/or chronic kidney insufficiency (glomerular filtration rate < 60 ml/min/1.73 m(2)) is related to the increasing number of components of the metabolic syndrome; that is, central obesity, elevated fasting blood glucose level, hypertriglycerides, low high-density lipoprotein cholesterol level and hypertension. Obesity-associated renal disease should be prevented or retarded by weight reduction following lifestyle modification (salt restriction, hypocaloric diet, aerobic exercise) or eventually by antiobesity medication or bariatric surgery. Rimonabant, a new antiobesity medication, showed beneficial potential effect in treating clusters of metabolic syndrome, which may ultimately suggest potential benefit in treating obesity-related glomerulopathy.
肥胖和超重是肾脏疾病的危险因素。其范围涵盖从伴有或不伴有局灶性或节段性肾小球硬化的肾小球肿大，到糖尿病肾病，再到肾癌和肾结石。肾损伤的首个迹象是微量白蛋白尿或显性蛋白尿，尤其是在伴有高血压的情况下。微量白蛋白尿和/或慢性肾功能不全（肾小球滤过率<60 ml/min/1.73 m²）的发生与代谢综合征各组分数量的增加相关；也就是说，与中心性肥胖、空腹血糖水平升高、高甘油三酯、低高密度脂蛋白胆固醇水平及高血压有关。肥胖相关性肾病应通过生活方式改变（限盐、低热量饮食、有氧运动）后的体重减轻来预防或延缓，最终可通过抗肥胖药物或减肥手术来实现。新型抗肥胖药物利莫那班在治疗代谢综合征群组方面显示出有益的潜在效果，这可能最终提示其在治疗肥胖相关性肾小球病方面具有潜在益处。
