Cignarelli Mauro, Lamacchia Olga
Unit of Endocrinology and Metabolic Diseases, Department of Medical Sciences, University of Foggia, Via Luigi Pinto 1, 71100 Foggia, Italy.
Nutr Metab Cardiovasc Dis. 2007 Dec;17(10):757-62. doi: 10.1016/j.numecd.2007.03.003. Epub 2007 Jul 2.
The prevalence of obesity worldwide has increased dramatically. Besides, an approximately two-fold higher rate of increase in mean BMI among the incident ESRD has been reported in the US population from 1995-2002. Chronic kidney disease (CKD) prevalence increases from 2.9% among adults with an ideal BMI to 4.5% among obese adults. The development of CKD is usually the culminating result of the interaction of multiple risk factors. Obesity represents one example of a multitoxicity state and given the background of genetic susceptibility and/or reduced nephron number, overweight may initiate renal remodeling and/or accelerate kidney failure. Obesity may be the number one preventable risk factor for CKD. Weight loss has indeed been shown to improve glomerular hemodynamics and reduce urine albumin excretion. Thus, obese patients with CKD should be counseled on the benefits of weight loss.
全球肥胖症的患病率急剧上升。此外，据报道，1995年至2002年美国人群中，新发终末期肾病患者的平均体重指数增长率高出约两倍。慢性肾脏病（CKD）的患病率在理想体重指数的成年人中为2.9%，在肥胖成年人中则为4.5%。CKD的发生通常是多种危险因素相互作用的最终结果。肥胖是一种多毒性状态的例子，在遗传易感性和/或肾单位数量减少的背景下，超重可能引发肾脏重塑和/或加速肾衰竭。肥胖可能是CKD头号可预防的危险因素。事实上，体重减轻已被证明可改善肾小球血流动力学并减少尿白蛋白排泄。因此，应向患有CKD的肥胖患者宣传体重减轻的益处。
