Mathew Anna V, Okada Shinichi, Sharma Kumar
Center for Renal Translational Medicine, University of California-San Diego/Veterans Affairs San Diego Healthcare System, CA 92093-0711, USA.
Curr Diabetes Rev. 2011 Jan;7(1):41-9. doi: 10.2174/157339911794273928.
Obesity is a risk factor for both de novo disease and as a complication of existing chronic kidney disease. Obesity related disease is characterized by albuminuria, glomerulomegaly and secondary focal glomerulosclerosis. Traditionally altered renal hemodynamics causing hyperfiltration and upregulated renin angiotensin system have been associated with these changes. Recently identified circulating factors produced by fat stores such as adiponectin, leptin and inflammatory markers have shown to directly affect the cells in the renal glomeruli and cause pathological changes. Weight loss, blockade of the renin angiotensin system and restoration of adipokine levels may be beneficial to ameliorate the progression of obesity related disease.
肥胖既是新发疾病的危险因素,也是现有慢性肾脏病的并发症。肥胖相关疾病的特征是蛋白尿、肾小球肿大和继发性局灶性肾小球硬化。传统上,导致超滤过的肾血流动力学改变和肾素-血管紧张素系统上调与这些变化有关。最近发现,脂肪组织产生的循环因子,如脂联素、瘦素和炎症标志物,已被证明可直接影响肾小球中的细胞并引起病理变化。体重减轻、肾素-血管紧张素系统阻断和脂肪因子水平恢复可能有助于改善肥胖相关疾病的进展。