Obesity and kidney disease: hidden consequences of the epidemic.

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obesity 58 endocrinologydiseases
Insulin 1 endocrinologydiseasesdrugs
diabetes mellitus 3 endocrinologydiseases
hyperinsulinemia 1 endocrinologydiseases

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Select Drug Character Offset Drug Term Instance
Insulin 10943 behind the increased risk of kidney cancers observed in obese individuals are less well characterized. Insulin resistance, and the consequent chronic hyperinsulinemia and increased production of insulin-like growth
Select Disease Character Offset Disease Term Instance
diabetes mellitus 5965 possible mediators of obesity’s cardiovascular and metabolic effects, such as high blood pressure and diabetes mellitus , suggesting that obesity may affect kidney function through mechanisms in part unrelated to these complications
diabetes mellitus 8025 deleterious renal consequences of obesity may be mediated by downstream comorbid conditions such as diabetes mellitus or hypertension, but there are also effects of adiposity that could impact the kidneys directly induced
diabetes mellitus 8679 whereby obesity causes chronic kidney disease (CKD). RAAS: renin-angiotensin-aldosterone system; DM: diabetes mellitus ; HTN: hypertension; CVD: cardiovascular disease.These various effects result in specific pathological
hyperinsulinemia 10990 observed in obese individuals are less well characterized. Insulin resistance, and the consequent chronic hyperinsulinemia and increased production of insulin-like growth factor 1 and of numerous complex secondary humoral effects
obesity 584 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
obesity 838 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
obesity 1122 kidney cancer. This year, the World Kidney Day will promote education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that
obesity 1675 direct impact on the development of CKD and end-stage renal disease (ESRD). In individuals affected by obesity , a compensatory mechanism of hyperfiltration likely occurs to meet the heightened metabolic demands
obesity 1962 damage the kidney structure and raise the risk of developing CKD in the long-term.The good news is that obesity , as well as the related CKD, are largely preventable. Education and awareness of the risks of obesity
obesity 2064 obesity, as well as the related CKD, are largely preventable. Education and awareness of the risks of obesity and a healthy lifestyle, including proper nutrition and exercise, can dramatically help in preventing
obesity 2174 and a healthy lifestyle, including proper nutrition and exercise, can dramatically help in preventing obesity and kidney disease. This article reviews the association of obesity with kidney disease on the occasion
obesity 2242 dramatically help in preventing obesity and kidney disease. This article reviews the association of obesity with kidney disease on the occasion of the 2017 World Kidney Day.Epidemiology of obesity in adults and
obesity 2331 association of obesity with kidney disease on the occasion of the 2017 World Kidney Day.Epidemiology of obesity in adults and childrenOver the last 3 decades, the prevalence of overweight and obese adults (BMI ≥25
obesity 2538 ≥25 kg/m2) worldwide has increased substantially ([1]). In the USA, the age-adjusted prevalence of obesity in 2013-2014 was 35% among men and 40.4% among women ([2]). The problem of obesity also affects children.
obesity 2621 age-adjusted prevalence of obesity in 2013-2014 was 35% among men and 40.4% among women ([2]). The problem of obesity also affects children. In the USA in 2011-2014, the prevalence of obesity was 17% and extreme obesity
obesity 2695 women ([2]). The problem of obesity also affects children. In the USA in 2011-2014, the prevalence of obesity was 17% and extreme obesity 5.8% among youth 2-19 years of age. The rise in obesity prevalence is also
obesity 2723 obesity also affects children. In the USA in 2011-2014, the prevalence of obesity was 17% and extreme obesity 5.8% among youth 2-19 years of age. The rise in obesity prevalence is also a worldwide concern ([3],[4]),
obesity 2779 the prevalence of obesity was 17% and extreme obesity 5.8% among youth 2-19 years of age. The rise in obesity prevalence is also a worldwide concern ([3],[4]), as it is projected to grow by 40% across the globe
obesity 3020 middle-income countries are now showing evidence of transitioning from normal weight to overweight and obesity as parts of Europe and the United States did decades ago ([5]). This increasing prevalence of obesity
obesity 3122 obesity as parts of Europe and the United States did decades ago ([5]). This increasing prevalence of obesity has implications for cardiovascular disease (CVD) and also for CKD. A high body mass index (BMI) is
obesity 3307 body mass index (BMI) is one of the strongest risk factors for new-onset CKD ([6],[7]).Definitions of obesity are most often based on BMI [i.e., weight (kilograms) divided by the square height (meters)]. A BMI
obesity 4219 respectively, for women. WHR has been shown to be superior to BMI for the correct classification of obesity in CKD.Association of obesity with CKD and other renal complicationsNumerous population-based studies
obesity 4249 has been shown to be superior to BMI for the correct classification of obesity in CKD.Association of obesity with CKD and other renal complicationsNumerous population-based studies have shown an association between
obesity 4375 renal complicationsNumerous population-based studies have shown an association between measures of obesity and both the development and the progression of CKD (Table 1). Higher BMI is associated with the presence
obesity 4917 over time ([14]), and with the incidence of ESRD ([15][16][17]–[18]). Elevated BMI levels, class II obesity and above, have been associated with more rapid progression of CKD in patients with pre-existing CKD
obesity 5087 CKD in patients with pre-existing CKD ([19]). A few studies examining the association of abdominal obesity using WHR or WC with CKD, describe an association between higher girth and albuminuria ([20]), decreased
obesity 5302 GFR ([8]) or incident ESRD ([21]) independent of BMI level.Table 1Stides examining the association of obesity with various measures of chronic kidney disease.Higher visceral adipose tissue measured by computed
obesity 5563 prevalence of albuminuria in men ([22]). The observation of a BMI-independent association between abdominal obesity and poorer renal outcomes is also described in relationship with mortality in patients with ESRD ([23])
obesity 5792 transplant ([24]), and suggests a direct role of visceral adiposity. In general, the associations between obesity and poorer renal outcomes persist even after adjustments for possible mediators of obesity’s cardiovascular
obesity 5883 between obesity and poorer renal outcomes persist even after adjustments for possible mediators of obesity ’s cardiovascular and metabolic effects, such as high blood pressure and diabetes mellitus, suggesting
obesity 6000 cardiovascular and metabolic effects, such as high blood pressure and diabetes mellitus, suggesting that obesity may affect kidney function through mechanisms in part unrelated to these complications (see next section).The
obesity 6140 through mechanisms in part unrelated to these complications (see next section).The deleterious effect of obesity on the kidneys extends to other complications such as nephrolithiasis and kidney malignancies. Higher
obesity 6843 cancers attributable to excess weight ([28]). Another large analysis examining the global burden of obesity on malignancies estimated that 17 and 26% of all kidney cancers in men and women, respectively, were
obesity 7014 in men and women, respectively, were attributable to excess weight ([29]). The association between obesity and kidney cancers was consistent in both men and women, and across populations from different parts
obesity 7338 the cancers examined in this meta-analysis, kidney cancers had the third highest risk associated with obesity (relative risk per 5 kg/m2 higher BMI=1.24, 95%CI=1.20-1.28, P<0.0001) ([30]).Mechanisms of action underlying
obesity 7477 higher BMI=1.24, 95%CI=1.20-1.28, P<0.0001) ([30]).Mechanisms of action underlying the renal effects of obesity Obesity results in complex metabolic abnormalities, which have wide-ranging effects on diseases affecting
obesity 7632 abnormalities, which have wide-ranging effects on diseases affecting the kidneys. The exact mechanisms whereby obesity may worsen or cause CKD remain unclear. The fact that most obese individuals never develop CKD, and
obesity 7959 alone is not sufficient to induce kidney damage ([31]). Some of the deleterious renal consequences of obesity may be mediated by downstream comorbid conditions such as diabetes mellitus or hypertension, but there
obesity 8586 production of insulin and insulin resistance ([39],[40]).Figure 1Putative mechanisms of action whereby obesity causes chronic kidney disease (CKD). RAAS: renin-angiotensin-aldosterone system; DM: diabetes mellitus;
obesity 9320 ([46]), and focal or segmental glomerulosclerosis ([41]) (Figure 2). The incidence of the so-called obesity -related glomerulopathy (ORG) has increased ten-fold between 1986 and 2000 ([41]). Importantly, ORG often
obesity 10357 in urinary citrate, also contributing to kidney stone risk. The insulin resistance characteristic of obesity may also predispose to nephrolithiasis ([51]) through its impact on tubular Na-H exchanger ([52]) and
obesity 11584 for a nuanced approachConsidering the above evidence about the overwhelmingly deleterious effects of obesity on various disease processes, it is seemingly counterintuitive that obesity has been consistently associated
obesity 11660 deleterious effects of obesity on various disease processes, it is seemingly counterintuitive that obesity has been consistently associated with lower mortality rates in patients with advanced CKD ([19],[61])
obesity 12170 seemingly protective effect of a high BMI is the result of the imperfection of BMI as a measure of obesity , as it does not differentiate the effects of adiposity from those of higher non-adipose tissue. Indeed,
obesity 13615 ([71]), which are associated with better outcomes. Other hypothetically beneficial characteristics of obesity include a more stable hemodynamic status with mitigation of stress responses and heightened sympathetic
obesity 14060 binding of circulating endotoxins ([75]) by the characteristically higher cholesterol levels seen in obesity ; and sequestration of uremic toxins by adipose tissue ([76]).Potential interventions for management
obesity 14171 and sequestration of uremic toxins by adipose tissue ([76]).Potential interventions for management of obesity Obesity engenders kidney injury via direct mechanisms through deranged synthesis of various adipose tissue
obesity 14500 conditions that rank among the strongest risk factors for CKD. Perhaps due to the survival advantage of obesity in CKD, the prevalence of end stage kidney disease is on the rise both in the USA ([77]) and in Europe
obesity 14650 disease is on the rise both in the USA ([77]) and in Europe ([78]). Strategies for controlling the obesity -related CKD epidemic at population level and for countering the evolution of CKD toward kidney failure
obesity 15365 program that sets 10-year health targets for health promotion and prevention, focuses both on CKD and obesity . Surveys to detect obese patients, particularly those with a high risk of CKD (e.g., hypertensive and/or
obesity 17065 angiotensin receptor blockers ([80]). This system may serve as a platform to improve the prevention of obesity -related CKD. Campaigns aiming at reducing the obesity burden are now at center stage worldwide and are
obesity 17119 serve as a platform to improve the prevention of obesity-related CKD. Campaigns aiming at reducing the obesity burden are now at center stage worldwide and are strongly recommended by the WHO, and it is expected
obesity 17278 strongly recommended by the WHO, and it is expected that these campaigns will reduce the incidence of obesity -related complications, including CKD. However, obesity-related goals in obese CKD patients remain vaguely
obesity 17333 these campaigns will reduce the incidence of obesity-related complications, including CKD. However, obesity -related goals in obese CKD patients remain vaguely formulated, largely because of the paucity of high-level
obesity 17476 remain vaguely formulated, largely because of the paucity of high-level evidence studies to modify obesity in CKD patients ([81]).Prevention of CKD progression in obese people with CKDObservational studies in
obesity 17766 with metabolic abnormalities per se predicts a higher risk for incident CKD ([82]), suggesting that obesity per se may engender renal dysfunction and kidney damage even without diabetes or hypertension (see above).
obesity 19787 justified, particularly for the control of diabetes and hypertension. As the independent effect of obesity control on the incidence and progression of CKD is difficult to disentangle from the effects of hypertension
obesity 20126 patients remains unwarranted. These considerations suggest that a therapeutic approach to overweight and obesity in patients with advanced CKD or other significant comorbid conditions has to be pursued carefully,
obesity 20411 complications of weight loss over the life span of the individual patient.ConclusionsThe worldwide epidemic of obesity affects the Earth’s population in many ways. Diseases of the kidneys, including CKD, nephrolithiasis
obesity 20581 kidneys, including CKD, nephrolithiasis and kidney cancers are among the more insidious effects of obesity , but which nonetheless have wide ranging deleterious consequences, ultimately leading to significant
obesity 20818 mortality and excess costs to individuals and the entire society. Population-wide interventions to control obesity could have beneficial effects in preventing the development or delaying the progression of CKD. It is
obesity 21066 community to devise long-ranging strategies towards improving the understanding of the links between obesity and kidney diseases, and to determine optimal strategies to stem the tide. The 2017 World Kidney Day

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