Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
Med Clin North Am. 2013 Jan;97(1):59-74. doi: 10.1016/j.mcna.2012.10.010. Epub 2012 Nov 27.
Obesity and diabetes are major causes of CKD and ESRD, and are thus enormous health concerns worldwide. Both obesity and diabetes, along with other elements of the metabolic syndrome including hypertension, are highly interrelated and contribute to the development and progression of renal disease. Studies show that multiple factors act in concert to initially cause renal vasodilation, glomerular hyperfiltration, and albuminuria, leading to the development of glomerulopathy. The coexistence of hypertension contributes to the disease progression, which, if not treated, may lead to ESRD. Although early intervention and management of body weight, hyperglycemia, and hypertension are imperative, novel therapeutic approaches are also necessary to reduce the high morbidity and mortality associated with both obesity-related and diabetes-related renal disease.
肥胖症和糖尿病是慢性肾脏病和终末期肾病的主要病因,因此也是全球范围内的重大健康关切。肥胖症和糖尿病以及代谢综合征的其他因素(包括高血压)之间存在高度关联,并且会导致肾脏疾病的发生和发展。研究表明,多种因素协同作用,最初会导致肾脏血管舒张、肾小球高滤过和白蛋白尿,从而导致肾小球病变的发生。高血压的共存会促进疾病的进展,如果不加以治疗,可能会导致终末期肾病。虽然早期干预和管理体重、高血糖和高血压至关重要,但也需要新的治疗方法来降低与肥胖症相关和糖尿病相关的肾脏疾病相关的高发病率和死亡率。