Management of obesity-induced kidney disease: a critical review of the literature

Abstract

It is well established that obesity is a risk factor for the development of chronic kidney disease (CKD) and may promote the progression to end stage renal disease (ESRD). Therefore, it is strongly suggested that reduction of body weight can be an important intervention in order to reduce the prevalence of renal impairment. The current article describes extensively the already published trials which have studied the association between weight loss and kidney disease. The weight management programs include surgical and non-surgical interventions (low-calorie diet, aerobic exercise, drug-induced weight loss, combination treatment). The focus has been placed on the following renal function markers: albuminuria, proteinuria, glomerular filtration rate (GFR), and creatinine clearance. This review also aims to clarify challenges that clinicians have to deal with in everyday practice regarding the management of obesity-induced kidney disease (degree of weight loss, duration of the weight loss program, early initiation of the intervention).