Nephrol Dial Transplant (2003) 18: 2471-2474
© 2003 European Renal Association-European Dialysis and Transplant Association
Editorial Comment
After all those fat years: renal consequences of obesity
Department of Medicine, Division of Nephrology, Rheumatology and Osteology, University of Hamburg, Hamburg, Germany
Correspondence and offprint requests to: Gunter Wolf, MD, University of Hamburg, University Hospital Eppendorf, Department of Medicine, Division of Nephrology, Rheumatology and Osteology, Pavilion N26, Martinistraße 52, D-20246 Hamburg, Germany. Email: Wolf@uke.uni-hamburg.de
Keywords: adipocyte; diabetes type 2; hypertension; leptin; obesity; progression of renal disease
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Bigger is not better |
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Our genetic background and physiological homeostasis, orchestrated through endocrine and neuronal networks, are optimized for a world with intermittent food supply and permit us to survive periods of starvation [1]. However, these systems are counterproductive in our current industrial society with fast-food restaurants, an abundance of high energy food and an increasingly sedentary life-style. The consequence is an alarming increase in obese adults and, even more disturbing, of overweight children [1]. The consequences of obesity such as the metabolic syndrome with its ultimate development of type 2 diabetes mellitus, cardiovascular diseases, an increased incidence of certain types of cancer, musculoskeletal disorders and pulmonary diseases are well known. What about renal diseases? Almost 30 years ago, Weisinger et al. [2] described focal-segmental glomerulosclerosis with nephrotic syndrome in four extremely obese patients. Only two of them exhibited hypertension by office blood pressure measurements [2
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Adipose tissue as a source of hormones and cytokines |
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What about leptin? |
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Obesity and kidney function and structure |
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What could be done? |
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Conclusion |
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