Obesity, insulin resistance and kidney disease risk: insights into the relationship.

PURPOSE OF REVIEW: The prevalence of obesity is constantly rising in Western societies, driving the upward trends in the prevalence of diabetes, hypertension and dyslipidemia, within the frame of the metabolic syndrome. This increase may have an adverse impact not only on cardiovascular but also on chronic kidney disease. RECENT
FINDINGS: Several observational studies, including recent wide-scale cross-sectional and prospective cohort studies, have consistently shown that increased body mass index as well as insulin resistance and increased fasting insulin levels are associated with chronic kidney disease, even after adjustment for related disorders. These associations are supported by a considerable number of accumulating background studies that provide several alternative mechanisms through which excess body fat or insulin resistance/hyperinsulinemia can induce renal injury.
SUMMARY: Obesity and insulin resistance are important and potentially modifiable risk factors for the development and progression of chronic kidney disease. Efforts to prevent and treat these factors can have a beneficial impact on the incidence of chronic kidney disease and related morbidities. Future research should delineate the above associations and identify the optimal prevention strategies for obese patients at risk for chronic kidney disease.