[Obesity-related glomerulopathy: Mechanisms of development, clinical course]

Area of Science:

• Nephrology
• Endocrinology
• Public Health

Background:

• Obesity is a global epidemic of non-communicable diseases.
• Kidney damage from obesity is an independent risk factor for renal failure.
• Obesity-related glomerulopathy (OGP) is characterized by proteinuria in individuals with a BMI >30 kg/m² without other kidney damage causes.

Purpose of the Study:

• To describe the pathogenesis, morphology, and clinical presentation of obesity-related glomerulopathy (OGP).
• To highlight OGP as a significant cause of kidney injury in obese individuals.

Main Methods:

• Review of existing literature on obesity-related glomerulopathy.
• Analysis of multifactorial pathogenesis including hemodynamic disorders, hormonal imbalances, and lipid accumulation.
• Description of morphological changes like glomerular hypertrophy and focal segmental glomerulosclerosis.
• Characterization of clinical manifestations including albuminuria, hypertension, and dyslipidemia.

Main Results:

• Pathogenesis involves renal hyperfiltration, hormonal dysregulation (hyperleptinemia, RAAS activation, low adiponectin), and ectopic lipid deposition.
• Morphological findings include oligonephronia, glomerular/tubular hypertrophy, FSGS, podocyte damage, and fatty kidney.
• Clinical features include gradual albuminuria (Stage A3), partial nephrotic syndrome in one-third of cases, and high prevalence of hypertension (>50%) and dyslipidemia (>80%).

Conclusions:

• Obesity-related glomerulopathy is a distinct kidney injury in obesity with specific pathological and clinical features.
• OGP can progress to advanced chronic kidney disease (Stages IV-V) over 20-30 years.
• Early recognition and management of OGP are crucial for preventing long-term renal damage.