Obesity and Kidney Disease Study

Between 1975 and 2020, global obesity climbed nearly thrice. Many investigations revealed an increase in obesity-related kidney disease, the majority of which were focal segmental glomerulosclerosis (FSGS).

In a new study, it was shown that obesity rates in glomerulonephritis (GN) patients are rising. Obese people had a much greater frequency of FSGS, DMN, and HT-N, despite the fact that IgAN is the most frequent type of glomerulonephritis (GN). Obesity was associated with an increased risk of end-stage renal disease (ESKD) development in individuals with GN, particularly in minimal change disease and lupus nephritis patients.

This study was conducted by Tae-bum Kim and team, and the abstract of this study was published in The American Society of Nephrology on 4th November, 2021.

Between 1979 and 2018, a total of 14,833 adult patients who had renal biopsy and had a body mass index (BMI) were identified in 18 tertiary institutions. Obesity was classified as having a BMI of 30 kg/m². We studied the prevalence of certain types of glomerulonephritis in obese people, as well as the impact of obesity on mortality and ESKD.

Obese individuals with glomerular disease rose about 12.8-fold during a 40-year period between 1979-1988 (0.6%) and 2009-2018 (7.7%). IgA nephropathy (IgAN) is the most common in GN patients with obesity (33.7%), followed by:

• FSGS (13.3%)
• Minimal change disease (MCD) (10.8%)
• Membranous nephropathy (10.6%)
• Diabetic nephropathy (DMN) (6.0%)
• Lupus nephritis (LN) (2.7%)
• Hypertensive nephropathy (HT-N) (2.6%)

Obese individuals had significantly greater rates of FSGS, DMN, and HT-N than non-obese patients. Obesity was associated with a 1.39-fold greater risk of ESKD advancement in total patients during a 93.8-month follow-up period. Obesity increased the likelihood of ESKD development in MCD and LN. Obesity was not linked with ESKD in patients with FSGS, DMN, or HT-N. Obesity was not connected with death in GN patients, whereas it was associated with mortality in MCD patients.

"Obese MCD patients had decreased renal function and a higher percentage of global sclerosis, and obese MCD and lupus nephritis patients had persistent proteinuria after diagnosis," the researchers' team stated.

Reference: Kim TB, Min HJ, Son YB, et al. The impact of obesity on glomerulonephritis: a multicenter cohort study of kidney biopsy over 40 years. Presented at: Kidney Week 2021; November 2-7, 2021. Presentation: PO1565.