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Hipertensión 2008;25:61-9 - DOI: 10.1016/S1889-1837(08)71738-0
Relación entre obesidad y desarrollo de insuficiencia renal
Relationship between obesity and development of kidney failure
E. Morales Ruiz, , M. Praga Terente
Servicio de Nefrología. Hospital Doce de Octubre. Madrid. España
Recibido 20 noviembre 2006, Aceptado 18 junio 2007
Resumen

The incidence of obesity-related glomerulopathy has been reaching tremendous proportions over the last decade. The most frequently found lesion in kidney biopsies of obese patients with proteinuria is focal segmental glomerulosclerosis. Different epidemiological studies have demonstrated that obesity is an important risk factor for the development of proteinuria and renal failure in the normal population. The mechanisms by which obesity may induce proteinuria are unknown. However, there is evidence that points towards the participation of hemodynamic, hyperlipidemic factors and an increase of vasoactive and fibrogenic substances, which include angiotensin II, insulin, leptin and growth transforming factor-beta. Weight loss produces a marked reduction of the renin-angiotensin- aldosterone system. Body mass index increase is a risk factor for the development of proteinuria of kidney failure in patients with decreased functioning kidney mass (nephrectomized or renal agenesis). Although the angiotensin converting enzyme inhibitors have demonstrated a striking favorable influence, only temporally, weight loss produces a decrease in proteinuria in chronic proteinuric nephropathies of any disease. Prevention and treatment of obesity should be a primary objective within diabetic and no-diabetic patients with chronic kidney disease.

Palabras clave
obesidad, proteinuria, hiperfiltración, glomeruloesclerosis focal
Key words
obesity, proteinuria, hyperfiltration, focal glomeruloesclerosis
El Texto completo solo está disponible en PDF
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Correspondencia: Servicio de Nefrología. Hospital Doce de Octubre. Avda. Andalucía, s/n. 28041 Madrid. España.
Copyright © 2008. Sociedad Espa??ola de Hipertension-Liga Espa??ola para la Lucha de la Hipertensi??n Arterial (SEH-LELHA)