Kovesdy Csaba P
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
Clin J Am Soc Nephrol. 2025 May 1;20(5):742-754. doi: 10.2215/CJN.0000000704. Epub 2025 Mar 14.
Obesity is a worldwide epidemic with a future projected growth of 40% over 10 years. Obesity increases the risk of diabetes, hypertension, and cardiovascular disease, and it also leads to higher risk of CKD, through both direct and indirect mechanisms. Although obesity is a feature of overnutrition and is associated with poor outcomes in the general population, obese individuals with CKD often display complex metabolic patterns such as sarcopenic obesity, and obesity can be associated with better survival in individuals with advanced CKD. Weight loss interventions are proven to improve glycemic control and cardiovascular risk factors, and successful weight loss is associated with improved albuminuria in patients with preexisting CKD. The long-term effects of weight loss interventions on kidney function and on survival in patients with CKD are less well studied, and hence, such interventions should be individualized.
肥胖是一种全球性的流行病，预计未来10年将增长40%。肥胖会增加患糖尿病、高血压和心血管疾病的风险，还会通过直接和间接机制导致患慢性肾脏病（CKD）的风险更高。尽管肥胖是营养过剩的一个特征，并且与普通人群的不良预后相关，但患有CKD的肥胖个体通常表现出复杂的代谢模式，如肌少性肥胖，而且肥胖可能与晚期CKD患者的更好生存相关。减重干预措施已被证明可改善血糖控制和心血管危险因素，成功减重与已有CKD患者的蛋白尿改善相关。减重干预措施对CKD患者肾功能和生存的长期影响研究较少，因此，此类干预措施应个体化。
