Kasiske B L, Crosson J T
Arch Intern Med. 1986 Jun;146(6):1105-9.
During a four-year period, 17 massively obese patients without clinically apparent systemic disease underwent renal biopsy for marked proteinuria. Clinical information and biopsy results were compared with those in 34 normal-body-weight controls matched for age, sex, and similar presentation. Histopathologic changes characteristic of focal glomerulosclerosis were found in nine (53%) of the obese patients and two (6%) of the controls. In addition, five (29%) of the obese patients had occult diabetic nephropathy, while no diabetic changes were seen in controls. Clinically, obese patients resembled controls in most respects. Serum albumin level, however, was higher than in controls (3.5 +/- 0.2 vs 2.5 +/- 0.1 g/dL). Indeed, obese patients with focal glomerulosclerosis had normal serum albumin levels (4.0 +/- 0.1 g/dL). Thus, primary renal disease in massively obese patients with marked proteinuria differed in several important respects from that seen in normal-body-weight patients with a similar degree of proteinuria.
在四年期间，17名无明显临床系统性疾病的极度肥胖患者因显著蛋白尿接受了肾活检。将临床信息和活检结果与34名年龄、性别匹配且表现相似的正常体重对照者进行了比较。在9名（53%）肥胖患者和2名（6%）对照者中发现了局灶节段性肾小球硬化的组织病理学改变。此外，5名（29%）肥胖患者存在隐匿性糖尿病肾病，而对照者未发现糖尿病改变。临床上，肥胖患者在大多数方面与对照者相似。然而，血清白蛋白水平高于对照者（3.5±0.2 vs 2.5±0.1 g/dL）。实际上，患有局灶节段性肾小球硬化的肥胖患者血清白蛋白水平正常（4.0±0.1 g/dL）。因此，有显著蛋白尿的极度肥胖患者的原发性肾脏疾病在几个重要方面与蛋白尿程度相似的正常体重患者不同。
