Obesity-related kidney disease.

The prevalence of chronic kidney disease (CKD) is increasing, and the epidemic of obesity is one of the causes. Obesity exacerbates hypertension as a risk factor for CKD, causing vasoconstriction and salt and water retention. Obesity also worsens glucose intolerance and insulin resistance as risk factors for CKD. Obesity targets the kidney by triggering novel pathways of intrarenal inflammation, recruiting professional immunologic cells through metaflammation. Obesity-related glomerulopathy has emerged as a distinct pathologic variant of focal segmental glomerulosclerosis. No definitive treatments have come about for obesity-related glomerulopathy, but among the most promising prospects is aggressive weight loss, including bariatric surgery.