Yang Shuting, Cao Chuqing, Deng Tuo, Zhou Zhiguang
Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, China.
Kidney Blood Press Res. 2020;45(4):510-522. doi: 10.1159/000507784. Epub 2020 Jun 4.
Obesity has become a major public health problem, and the prevalence of kidney diseases has increased in parallel. Among kidney diseases caused by metabolic disorders, obesity-related glomerulopathy (ORG) is secondary to obesity.
ORG is mainly caused by glomerular hyperfiltration, dysregulation of hormone and cytokine secretion in adipose tissues, and ectopic lipid accumulation in renal cells. ORG is pathologically characterized by glomerular hypertrophy, with or without focal and segmental glomerulosclerosis. Patients with ORG usually present with proteinuria concomitant with metabolic disorders such as dyslipidemia and hypertension. Weight loss, RAAS inhibitors, and improved insulin resistance can reduce the progression of ORG.
ORG is a growing renal pathological change in obese individuals, and a comprehensive understanding of the disease is pivotal to avoid its occurrence and improve quality of life for those with obesity. Key Messages:This review comprehensively describes the characteristics of ORG in pathological changes, clinical manifestations, pathogeneses and treatments.
肥胖已成为一个主要的公共卫生问题,同时肾脏疾病的患病率也在上升。在由代谢紊乱引起的肾脏疾病中,肥胖相关性肾小球病(ORG)继发于肥胖。
ORG主要由肾小球高滤过、脂肪组织中激素和细胞因子分泌失调以及肾细胞中异位脂质堆积引起。ORG的病理特征为肾小球肥大,伴有或不伴有局灶节段性肾小球硬化。ORG患者通常表现为蛋白尿,并伴有血脂异常和高血压等代谢紊乱。减肥、肾素-血管紧张素-醛固酮系统(RAAS)抑制剂以及改善胰岛素抵抗可减缓ORG的进展。
ORG是肥胖个体中日益增多的肾脏病理变化,全面了解该疾病对于避免其发生以及改善肥胖者的生活质量至关重要。关键信息:本综述全面描述了ORG在病理变化、临床表现、发病机制和治疗方面的特征。