Friedman Allon N, Kaplan Lee M, le Roux Carel W, Schauer Philip R
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Obesity, Metabolism, and Nutrition Institute, Massachusetts General Hospital, Boston, Massachusetts.
J Am Soc Nephrol. 2021 Apr;32(4):777-790. doi: 10.1681/ASN.2020101472. Epub 2021 Feb 18.
Obesity is a leading public health problem that currently affects over 650 million individuals worldwide. Although interest in the adverse effects of obesity has grown exponentially in recent years, less attention has been given to studying its management in individuals with CKD. This relatively unexplored area should be considered a high priority because of the rapid growth and high prevalence of obesity in the CKD population, its broad impact on health and outcomes, and its modifiable nature. This article begins to lay the groundwork in this field by providing a comprehensive overview that critically evaluates the available evidence related to obesity and kidney disease, identifies important gaps in our knowledge base, and integrates recent insights in the pathophysiology of obesity to help provide a way forward in establishing guidelines as a basis for managing obesity in CKD. Finally, the article includes a kidney-centric algorithm for management of obesity that can be used in clinical practice.
肥胖是一个主要的公共卫生问题，目前全球有超过6.5亿人受其影响。尽管近年来人们对肥胖的不良影响的关注度呈指数级增长，但对慢性肾脏病（CKD）患者肥胖管理的研究却较少受到关注。由于CKD人群中肥胖的快速增长和高患病率、其对健康和预后的广泛影响以及其可改变的性质，这个相对未被探索的领域应被视为高度优先事项。本文通过提供全面的概述来开始奠定该领域的基础，该概述批判性地评估了与肥胖和肾脏疾病相关的现有证据，确定了我们知识库中的重要差距，并整合了肥胖病理生理学的最新见解，以帮助为制定指南奠定基础，作为管理CKD患者肥胖的依据。最后，本文包括一种以肾脏为中心的肥胖管理算法，可用于临床实践。
