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Jan A. Krikken, Stephan J. L. Bakker, Gerjan J. Navis, Role of renal haemodynamics in the renal risks of overweight, Nephrology Dialysis Transplantation, Volume 24, Issue 6, June 2009, Pages 1708–1711, https://doi.org/10.1093/ndt/gfp081
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The complications of weight excess will heavily burden the health care system in the near future, considering the increasing prevalence of overweight and obesity [body mass index (BMI) > 25 and BMI > 30 kg/m 2 , respectively]. Renal damage is an emerging complication of weight excess. Fuelled by recent data, this paper will review the role of renal haemodynamics in the renal complications of weight excess.
The increasing impact of morbid obesity as a primary cause of renal damage is supported by a large series of renal biopsies, showing an increase in the prevalence of glomerulosclerosis associated with morbid obesity from 0.2 to 2% over a period of 15 years [ 1 ]. Recent studies, moreover, highlight the impact of less extreme weight excess as a risk factor for renal damage in patients with a pre-existing renal disorder [ 2 ], after uninephrectomy [ 3 ], in renal transplant recipients [ 4,5 ] and in the general population [ 6,7 ]. Whereas a BMI over 40 kg/m 2 is associated with a 7-fold increased long-term risk for end-stage renal disease (ESRD) as compared to lean subjects, a BMI over 25 kg/m 2 in young adults still carries a 3-fold elevated long-term risk of ESRD [ 6,7 ]. Together with the endemic prevalence of obesity and particularly overweight, these data suggest that weight excess will become the main risk factor for renal damage in the next decades, providing a major contribution to the increasing prevalence of ESRD worldwide [ 8 ].
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