Obesity and Kidney Disease: Hidden Consequences of the Epidemic

Authors

  • Csaba P. Kovesdy, MD Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA; Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
  • Susan Furth, MD Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
  • Carmine Zoccali, MD CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy

DOI:

https://doi.org/10.17140/NPOJ-3-e007

Keywords:

Obesity; Chronic kidney disease; Nephrolithiasis; Kidney cancer; Prevention

Abstract

Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by
40% in the next decade. This increasing prevalence has implications for the risk of diabetes,
cardiovascular disease and also for chronic kidney disease (CKD). A high body mass index
is one of the strongest risk factors for new-onset CKD. In individuals affected by obesity, a
compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased
body weight. The increase in intraglomerular pressure can damage the kidneys and raise the
risk of developing CKD in the long-term. The incidence of obesity-related glomerulopathy
has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for
nephrolithiasis, and for a number of malignancies including kidney cancer. This year the
“World Kidney Day” promotes education on the harmful consequences of obesity and its
association with kidney disease, advocating healthy lifestyle and health policy measures that
makes preventive behaviors an affordable option.

References

Forouzanfar MH, Alexander L, Anderson HR, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 386: 2287-2323. doi: 10.1016/S0140-6736(15)00128-2

Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016; 315: 2284-2291. doi: 10.1001/jama.2016.6458

Cattaneo A, Monasta L, Stamatakis E, et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev. 2010; 11: 389-398. doi: 10.1111/j.1467-789X.2009.00639.x

Olaya B, Moneta MV, Pez O, et al. Country-level and individual correlates of overweight and obesity among primary school children: A cross-sectional study in seven European countries. BMC Public Health. 2015; 15: 475. doi: 10.1186/s12889-015-1809-z

Subramanian SV, Perkins JM, Ozaltin E, Davey SG. Weight of nations: A socioeconomic analysis of women in low- to middle-income countries. Am J Clin Nutr. 2011; 93: 413-421. doi: 10.3945/ajcn.110.004820

Tsujimoto T, Sairenchi T, Iso H, et al. The dose-response relationship between body mass index and the risk of incident stage ≥3 chronic kidney disease in a general japanese population: The Ibaraki prefectural health study (IPHS). J Epidemiol. 2014; 24: 444- 451. doi: 10.2188/jea.JE20140028

Elsayed EF, Sarnak MJ, Tighiouart H, et al. Waist-to-hip ratio, body mass index, and subsequent kidney disease and death. Am J Kidney Dis. 2008; 52: 29-38. doi: 10.1053/j.ajkd.2008.02.363

Pinto-Sietsma SJ, Navis G, Janssen WM, de ZD, Gans RO, de Jong PE. A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Dis. 2003; 41: 733-741. doi: 10.1016/S0272-6386(03)00020-9

Foster MC, Hwang SJ, Larson MG, et al. Overweight, obesity, and the development of stage 3 CKD: The Framingham Heart Study. Am J Kidney Dis. 2008; 52: 39-48. doi: 10.1053/j.ajkd.2008.03.003

Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D. Obesity and prevalent and incident CKD: The hypertension detection and follow-up program. Am J Kidney Dis. 2005; 46: 587-594. doi: 10.1053/j.ajkd.2005.06.007

Chang A, Van HL, Jacobs DR Jr, et al. Lifestyle-related factors, obesity, and incident microalbuminuria: The CARDIA (Coro-nary Artery Risk Development in Young Adults) study. Am J Kidney Dis. 2013; 62: 267-275. doi: 10.1053/j.ajkd.2013.02.363

Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyren O. Obesity and risk for chronic renal failure. J Am Soc Nephrol. 2006; 17: 1695-1702. doi: 10.1681/ASN.2005060638

Gelber RP, Kurth T, Kausz AT, et al. Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis. 2005; 46: 871-880. doi: 10.1053/j.ajkd.2005.08.015

Lu JL, Molnar MZ, Naseer A, et al. Association of age and BMI with kidney function and mortality: A cohort study. Lancet Diabetes Endocrinol. 2015; 3: 704-714. doi: 10.1016/S2213-8587(15)00128-X

Munkhaugen J, Lydersen S, Wideroe TE, Hallan S. Prehypertension, obesity, and risk of kidney disease: 20-year follow-up of the HUNT I study in Norway. Am J Kidney Dis. 2009; 54: 638-646. doi: 10.1053/j.ajkd.2009.03.023

Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S. Body mass index and the risk of development of end-stage re-nal disease in a screened cohort. Kidney Int. 2004; 65: 1870-1876. Web site. http://www.kidney-international.org/article/S0085- 2538(15)49921-1/pdf. Accessed October 4, 2016.

Vivante A, Golan E, Tzur D, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med. 2012; 172: 1644-1650. doi: 10.1001/2013.jamainternmed.85

Hsu C, McCulloch C, Iribarren C, Darbinian J, Go A. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006; 144: 21-28. doi: 10.7326/0003-4819-144-1-200601030-00006

Lu JL, Kalantar-Zadeh K, Ma JZ, Quarles LD, Kovesdy CP. Association of body mass index with outcomes in patients with CKD. J Am Soc Nephrol. 2014; 25: 2088-2096. doi: 10.1681/ASN.2013070754

Thoenes M, Reil JC, Khan BV, et al. Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension. Vasc Health Risk Manag. 2009; 5: 577-585. doi: 10.2147/VHRM.S5207

Kramer H, Gutierrez OM, Judd SE, et al. Waist circumference, body mass index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2016; 67: 62-69. doi: 10.1053/j.ajkd.2015.05.023

Foster MC, Hwang SJ, Massaro JM, et al. Association of subcutaneous and visceral adiposity with albuminuria: The Framing-ham Heart Study. Obesity (Silver Spring). 2011; 19: 1284-1289. doi: 10.1038/oby.2010.308

Postorino M, Marino C, Tripepi G, Zoccali C. Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. J Am Coll Cardiol. 2009; 53: 1265-1272. doi: 10.1016/j.jacc.2008.12.040

Kovesdy CP, Czira ME, Rudas A, et al. Body mass index, waist circumference and mortality in kidney transplant recipients. Am J Transplant. 2010; 10: 2644-2651. doi: 10.1111/j.1600-6143.2010.03330.x

Scales CD Jr., Smith AC, Hanley JM, Saigal CS. Prevalence of kidney stones in the United States. Eur Urol. 2012; 62: 160-165. doi: 10.1016/j.eururo.2012.03.052

Curhan GC, Willett WC, Rimm EB, Speizer FE, Stampfer MJ. Body size and risk of kidney stones. J Am Soc Nephrol. 1998; 9: 1645-1652. Web site. http://jasn.asnjournals.org/content/9/9/1645.long. Accessed October 4, 2016.

Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005; 293: 455-462. doi: 10.1001/jama.293.4.455

Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: A population-based cohort study of 5.24 million UK adults. Lancet. 2014; 384: 755-765. doi: 10.1016/S0140-6736(14)60892-8

Arnold M, Pandeya N, Byrnes G, et al. Global burden of cancer attributable to high body-mass index in 2012: A population-based study. Lancet Oncol. 2015; 16: 36-46. doi: 10.1016/S1470-2045(14)71123-4

Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. Lancet. 2008; 371: 569-578. doi: 10.1016/S0140-6736(08)60269-X

Bluher M. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. Curr Opin Lipidol. 2010; 21: 38-43. doi: 10.1097/MOL.0b013e3283346ccc

Sharma K. The link between obesity and albuminuria: Adiponectin and podocyte dysfunction. Kidney Int. 2009; 76: 145-148. doi: 10.1038/ki.2009.137

Wolf G, Ziyadeh FN. Leptin and renal fibrosis. Contrib Nephrol. 2006; 151: 175-183. doi: 10.1159/000095328

Ellington AA, Malik AR, Klee GG, et al. Association of plasma resistin with glomerular filtration rate and albuminuria in hyper-tensive adults. Hypertension. 2007; 50: 708-714. doi: 10.1161/HYPERTENSIONAHA.107.095257

Bastard JP, Maachi M, Lagathu C, et al. Recent advances in the relationship between obesity, inflammation, and insulin resis-tance. Eur Cytokine Netw. 2006; 17(1): 4-12. Web site. http://www.jle.com/fr/revues/ecn/e-docs/recent_advances_in_the_relation-ship_between_obesity_inflammation_and_insulin_resistance_268297/article.phtml. Accessed October 4, 2016.

Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114: 1752-1761. doi: 10.1172/JCI200421625

Ruan XZ, Varghese Z, Moorhead JF. An update on the lipid nephrotoxicity hypothesis. Nat Rev Nephrol. 2009; 5: 713-721. doi: 10.1038/nrneph.2009.184

Ruster C, Wolf G. The role of the renin-angiotensin-aldosterone system in obesity-related renal diseases. Semin Nephrol. 2013; 33: 44-53. doi: 10.1016/j.semnephrol.2012.12.002

Oterdoom LH, de Vries AP, Gansevoort RT, de Jong PE, Gans RO, Bakker SJ. Fasting insulin modifies the relation between age and renal function. Nephrol Dial Transplant. 2007; 22: 1587-1592. doi: 10.1093/ndt/gfm037

Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988; 37: 1595-1607. doi: 10.2337/ diab.37.12.1595

Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD. Obesity-related glomerulopathy: An emerging epidemic. Kidney Int. 2001; 59: 1498-1509. Web site. http://www.kidney-international.org/article/S0085-2538(15)47626-4/pdf. Accessed October 4, 2016.

de Vries AP, Ruggenenti P, Ruan XZ, et al. Fatty kidney: Emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol. 2014; 2: 417-426. doi: 10.1016/S2213-8587(14)70065-8

Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS. Fatty kidney, hypertension, and chronic kidney disease: The Framingham Heart Study. Hypertension. 2011; 58: 784-790. doi: 10.1161/HYPERTENSIONAHA.111.175315

Henegar JR, Bigler SA, Henegar LK, Tyagi SC, Hall JE. Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol. 2001; 12: 1211-1217. Web site. http://jasn.asnjournals.org/content/12/6/1211.long. Accessed October 4, 2016.

Knight SF, Quigley JE, Yuan J, Roy SS, Elmarakby A, Imig JD. Endothelial dysfunction and the development of renal in-jury in spontaneously hypertensive rats fed a high-fat diet. Hypertension. 2008; 51: 352-359. doi: 10.1161/HYPERTENSIO-NAHA.107.099499

Tsuboi N, Utsunomiya Y, Kanzaki G, et al. Low glomerular density with glomerulomegaly in obesity-related glomerulopathy. Clin J Am Soc Nephrol. 2012; 7: 735-741. doi: 10.2215/CJN.07270711

Ribstein J, du CG, Mimran A. Combined renal effects of overweight and hypertension. Hypertension. 1995; 26: 610-615. doi: 10.1161/01.HYP.26.4.610

Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CY. Association of urinary pH with body weight in nephroli-thiasis. Kidney Int. 2004; 65: 1422-1425.

Lemann J Jr., Pleuss JA, Worcester EM, Hornick L, Schrab D, Hoffmann RG. Urinary oxalate excretion increases with body size and decreases with increasing dietary calcium intake among healthy adults. Kidney Int. 1996; 49: 200-208. doi: 10.1038/ki.1996.27

Siener R, Glatz S, Nicolay C, Hesse A. The role of overweight and obesity in calcium oxalate stone formation. Obes Res. 2004; 12: 106-113. doi: 10.1038/oby.2004.14

Taylor EN, Stampfer MJ, Curhan GC. Diabetes mellitus and the risk of nephrolithiasis. Kidney Int. 2005; 68: 1230-1235.

Klisic J, Hu MC, Nief V, et al. Insulin activates Na(+)/H(+) exchanger 3: Biphasic response and glucocorticoid dependence. Am J Physiol Renal Physiol. 2002; 283: F532-F539. doi: 10.1152/ajprenal.00365.2001

Chobanian MC, Hammerman MR. Insulin stimulates ammoniagenesis in canine renal proximal tubular segments. Am J Physiol. 1987; 253: F1171-F1177. Web site. http://ajprenal.physiology.org/content/253/6/F1171. Accessed October 4, 2016.

Daudon M, Lacour B, Jungers P. Influence of body size on urinary stone composition in men and women. Urol Res. 2006; 34: 193-199. doi: 10.1007/s00240-006-0042-8

Sinha MK, Collazo-Clavell ML, Rule A, et al. Hyperoxaluric nephrolithiasis is a complication of Roux-en-Y gastric bypass sur-gery. Kidney Int. 2007; 72: 100-107. Web site. http://cat.inist.fr/?aModele=afficheN&cpsidt=19046581. Accessed October 4, 2016.

Calle EE, Kaaks R. Overweight, obesity and cancer: Epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004; 4: 579-591. doi: 10.1038/nrc1408

Dalamaga M, Diakopoulos KN, Mantzoros CS. The role of adiponectin in cancer: A review of current evidence. Endocr Rev. 2012; 33: 547-594. doi: 10.1210/er.2011-1015

Lamas O, Marti A, Martinez JA. Obesity and immunocompetence. Eur J Clin Nutr. 2002; 56 (Suppl 3): S42-S45. doi: 10.1038/ sj.ejcn.1601484

Lim C, Savan R. The role of the IL-22/IL-22R1 axis in cancer. Cytokine Growth Factor Rev. 2014; 25: 257-271. doi: 10.1016/j. cytogfr.2014.04.005

Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010; 140: 883-899. doi: 10.1016/j. cell.2010.01.025

Kovesdy CP, Anderson JE, Kalantar-Zadeh K. Paradoxical association between body mass index and mortality in men with CKD not yet on dialysis. Am J Kidney Dis. 2007; 49: 581-591. doi: 10.1053/j.ajkd.2007.02.277

Kalantar-Zadeh K, Kuwae N, Wu DY, et al. Associations of body fat and its changes over time with quality of life and prospec-tive mortality in hemodialysis patients. Am J Clin Nutr. 2006; 83: 202-210. Web site. http://ajcn.nutrition.org/content/83/2/202. short. Accessed October 4, 2016.

Beddhu S, Pappas LM, Ramkumar N, Samore M. Effects of body size and body composition on survival in hemodialysis pa-tients. J Am Soc Nephrol. 2003; 14: 2366-2372. doi: 10.1097/01.ASN.0000083905.72794.E6

Curtis JP, Selter JG, Wang Y, et al. The obesity paradox: Body mass index and outcomes in patients with heart failure. Arch Intern Med. 2005; 165: 55-61. doi: 10.1001/archinte.165.1.55

Wilson DO, Rogers RM, Wright EC, Anthonisen NR. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis. 1989; 139: 1435-1438. doi: 10.1164/ajrc-cm/139.6.1435

Escalante A, Haas RW, Rincón ID. Paradoxical effect of body mass index on survival in rheumatoid arthritis: Role of comorbid-ity and systemic inflammation. Arch Intern Med. 2005; 165: 1624-1629. doi: 10.1001/archinte.165.14.1624

Kalantar-Zadeh K, Kilpatrick RD, Kuwae N, Wu DY. Reverse epidemiology: A spurious hypothesis or a hardcore reality? Blood Purif. 2005; 23: 57-63. doi: 10.1159/000082012

Noori N, Kopple JD, Kovesdy CP, et al. Mid-arm muscle circumference and quality of life and survival in maintenance hemo-dialysis patients. Clin J Am Soc Nephrol. 2010; 5: 2258-2268. doi: 10.2215/CJN.02080310

Dekker FW, de MR, van Dijk PC, Zoccali C, Jager KJ. Survival analysis: Time-dependent effects and time-varying risk factors. Kidney Int. 2008; 74: 994-997. doi: 10.1038/ki.2008.328

Snyder JJ, Foley RN, Gilbertson DT, Vonesh EF, Collins AJ. Body size and outcomes on peritoneal dialysis in the United States. Kidney Int. 2003; 64: 1838-1844. Web site. http://www.kidney-international.org/article/S0085-2538(15)49537-7/pdf. Accessed Oc-tober 4, 2016.

Lee PS, Sampath K, Karumanchi SA, et al. Plasma gelsolin and circulating actin correlate with hemodialysis mortality. J Am Soc Nephrol. 2009; 20: 1140-1148. doi: 10.1681/ASN.2008091008

Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Woo MA, Tillisch JH. The relationship between obesity and mortal-ity in patients with heart failure. J Am Coll Cardio. 2001; 38: 789-795. doi: 10.1016/S0735-1097(01)01448-6

Stenvinkel P, Marchlewska A, Pecoits-Filho R, et al. Adiponectin in renal disease: Relationship to phenotype and genetic varia-tion in the gene encoding adiponectin. Kidney Int. 2004; 65: 274-281.

Mohamed-Ali V, Goodrick S, Bulmer K, Holly JM, Yudkin JS, Coppack SW. Production of soluble tumor necrosis factor recep-tors by human subcutaneous adipose tissue in vivo. Am J Physiol. 1999; 277: E971-E975. Web site. http://europepmc.org/abstract/ med/10600783. Accessed October 4, 2016.

Rauchhaus M, Coats AJ, Anker SD. The endotoxin-lipoprotein hypothesis. Lancet. 2000; 356: 930-933. doi: 10.1016/S0140- 6736(00)02690-8

Jandacek RJ, Anderson N, Liu M, Zheng S, Yang Q, Tso P. Effects of yo-yo diet, caloric restriction, and olestra on tissue distribu-tion of hexachlorobenzene. Am J Physiol Gastrointest Liver Physiol. 2005; 288: G292-G299. doi: 10.1152/ajpgi.00285.2004

Kramer HJ, Saranathan A, Luke A, et al. Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol. 2006; 17(5): 1453-1459. doi: 10.1681/ASN.2005111241

Postorino M, Mancini E, D’Arrigo G, et al. Body mass index trend in haemodialysis patients: The shift of nutritional disorders in two Italian regions. Nephrol Dial Transplant. 2016. doi: 10.1093/ndt/gfw276

World Health Organization. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommuni-cable Diseases. 2009. Web site. http://apps.who.int/iris/bitstream/10665/44009/1/9789241597418_eng.pdf. Accessed October 4, 2016.

O’Donoghue DJ, Stevens PE. A decade after the KDOQI CKD/guidelines: A perspective from the United Kingdom. Am J Kid-ney Dis. 2012; 60: 740-742. doi: 10.1053/j.ajkd.2012.08.011

Bolignano D, Zoccali C. Effects of weight loss on renal function in obese CKD patients: A systematic review. Nephrol Dial Transplant. 2013; 28(Suppl 4): iv82-iv98. doi: 10.1093/ndt/gft302

Chang Y, Ryu S, Choi Y, et al. Metabolically healthy obesity and development of chronic kidney disease: A cohort study. Ann Intern Med. 2016; 164: 305-312. doi: 10.7326/M15-1323

Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013; 369: 145-154. doi: 10.1056/NEJMoa1212914

Mallamaci F, Ruggenenti P, Perna A, et al. ACE inhibition is renoprotective among obese patients with proteinuria. J Am Soc Nephrol. 2011; 22: 1122-1128. doi: 10.1681/ASN.2010090969

Friedman AN, Wolfe B. Is bariatric surgery an effective treatment for type II diabetic kidney disease? Clin J Am Soc Nephrol. 2015; 11: 528-535. Web site. http://cjasn.asnjournals.org/content/early/2015/10/08/CJN.07670715.abstract. Accessed October 4, 2016.

Chang AR, Chen Y, Still C, et al. Bariatric surgery is associated with improvement in kidney outcomes. 164-171. doi: 10.1016/j.kint.2016.02.039

Jamal MH, Corcelles R, Daigle CR, et al. Safety and effectiveness of bariatric surgery in dialysis patients and kidney transplanta tion candidates. Surg Obes Relat Dis. 2015; 11: 419-423. doi: 10.1016/j.soard.2014.09.022

Ahmadi SF, Zahmatkesh G, Ahmadi E, et al. Association of body mass index with clinical outcomes in non-dialysis-dependent chronic kidney disease: A systematic review and meta-analysis. Cardiorenal Med. Nephrol Open J Kidney Int. 2016; 90: -2015; 6: 37-49. doi: 10.1159/000437277 Page e14

Downloads

Published

2017-03-09

How to Cite

Csaba P. Kovesdy, MD, Susan Furth, MD, & Carmine Zoccali, MD. (2017). Obesity and Kidney Disease: Hidden Consequences of the Epidemic. Nephrology, 3–14. https://doi.org/10.17140/NPOJ-3-e007

Issue

Section

Articles