Department of Nephrology, The First Hospital of China Medical University, Shenyang, 110001, China.
Front Med. 2017 Sep;11(3):340-348. doi: 10.1007/s11684-017-0570-3. Epub 2017 Aug 8.
In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria ( < 3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin-angiotensin-aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.
鉴于全球肥胖发病率的迅速增加，肥胖已成为慢性肾脏病的一个独立危险因素。肥胖相关性肾小球病（ORG）的特征是存在或不存在局灶性和节段性肾小球硬化病变的肾小球肿大。在 ORG 免疫荧光中，IgM 和补体 3（C3）无特异性沉积在病变部位，没有免疫复合物型沉积物。ORG 相关的肾小球肿大和局灶性及节段性肾小球硬化可与其他肾脏病变叠加。ORG 下的机制很复杂，特别是血流动力学变化、炎症、氧化应激、细胞凋亡和功能下降的肾单位。这些机制与肥胖协同作用，导致终末期肾病。亚肾病范围蛋白尿（<3.5g/d）缓慢增加是 ORG 的最常见临床表现。已经开发了几种 ORG 的治疗方法。其中，肾素-血管紧张素-醛固酮系统阻断和减肥被证明是有效的。针对线粒体可能为 ORG 治疗提供一种新策略。然而，需要进一步的研究来更深入地了解 ORG。
