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Diabetic Nephropathy pp 65–80Cite as

Renal Disease in Obesity, Metabolic Syndrome and Diabesity

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Abstract

The pandemic of metabolic syndrome (MS), obesity, and type 2 diabetes – diabesity – may portend severe consequences in renal disease. In patients with obesity and particularly in extreme obesity, obesity-related glomerulopathy (ORG) is the classical picture of renal damage. ORG is characterized by glomerulomegaly and a secondary form of focal and segmental glomerulosclerosis. Interestingly, 50% of the cases with ORG also have “diabetoid changes” including mesangial expansion mainly in the absence of overt diabetes. This clearly indicates a common link between obesity and diabetes in the pathogenesis of renal disease. On the other hand, little evidence is available regarding pathogenesis, clinical evolution, and renal histology of renal disease in overweight and MS. In this chapter we will review the available evidence on renal disease in extreme obesity, moderate obesity overweight and MS. Major factors involved in renal disease in diabesity include hemodynamic changes leading to glomerular hyperfiltration, inflammation and lipotoxicity.

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Acknowledgments

E.P. is a researcher of the Program Ramón y Cajal (RYC-2014-16573). We thank the Instituto de Salud Carlos III for the following grants, PI13/00342 and PI16/01814, and REDINREN RD16/0009/0031 and the IMBRAIN project for support (FP7-RE6-POT-2012-CT2012-31637-IMBRAIN). M.N.D is a researcher of the REMAR group (Recerca en Malalties d’Afectació Renal research on kidney diseases) 2017-SGR-301. We thank the Instituto de Salud Carlos III for the REDINREN RD16/0009/0032. The authors also thank the DIABESITY working group of the ERA-EDTA.

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Authors and Affiliations

  1. University of La Laguna, ITB (Instituto de Tecnología Biomédicas), Hospital Universitario de Canarias, Nephrology Unit, Tenerife, Spain

    Esteban Porrini & Eduardo Salido

  2. Nephrology Department, Germans Trias i Pujol University Hospital, Badalona, Spain

    Maruja Navarro-Díaz

  3. REMAR Group, Health Science Research Institute Germans Trias i Pujol, Can Ruti Campus, Badalona, Spain

    Maruja Navarro-Díaz

  4. Autonomous University of Barcelona, Bellaterra, Spain

    Maruja Navarro-Díaz

  5. University of La Laguna, Pathology Department, Hospital Universitario de Canarias, Tenerife, Spain

    Rosa Rodríguez-Rodríguez & Eduardo Salido

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  1. Esteban Porrini
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  3. Rosa Rodríguez-Rodríguez
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Editors and Affiliations

  1. Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands

    Joris J. Roelofs

  2. Department of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands

    Liffert Vogt

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Porrini, E., Navarro-Díaz, M., Rodríguez-Rodríguez, R., Salido, E. (2019). Renal Disease in Obesity, Metabolic Syndrome and Diabesity. In: Roelofs, J., Vogt, L. (eds) Diabetic Nephropathy. Springer, Cham. https://doi.org/10.1007/978-3-319-93521-8_5

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