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Massive obesity and the kidney. A morphologic and statistical study
The American Journal of Pathology
|October 1, 1975
Summary
Obese patients with Pickwickian syndrome exhibit enlarged glomeruli, primarily due to vascular changes. This kidney abnormality is linked to increased blood volume and hypoxia, not polycythemia.
Area of Science:
- Nephrology
- Obesity Medicine
- Pathology
Background:
- Gross obesity and Pickwickian syndrome are associated with various health complications.
- Renal morphology in such patients is not well-characterized.
- Understanding kidney changes is crucial for managing associated risks.
Purpose of the Study:
- To investigate the renal morphological changes in patients with obesity and Pickwickian syndrome.
- To identify specific alterations in glomerular structure.
- To explore potential contributing factors to observed renal abnormalities.
Main Methods:
- Autopsy study of 5 patients with gross obesity and Pickwickian syndrome features.
- Normal renal function was confirmed in the studied patients.
- Quantitative measurements of glomerular areas were performed and compared to controls.
Main Results:
- Statistically significant glomerular enlargement (glomerulomegaly) was observed.
- Glomerulomegaly resulted from vascular dilatation and mesangial cell changes.
- Factors like increased blood volume, hypoxia, and elevated right ventricular pressure were associated with this enlargement.
Conclusions:
- Glomerulomegaly is a key renal finding in obese patients with Pickwickian syndrome.
- Vascular and mesangial alterations drive this enlargement.
- Hypoxia and hemodynamic changes, not polycythemia, are implicated in the pathogenesis.
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