Open AccessAnything New in the Treatment of Obesity in Obese Patients with CKD?
Author(s) -
José Javier Navarro Pérez,
Lucia Cordero Garcia-Galán,
Lucia Aubert Girbal,
Manuel Praga,
Julio Pascual,
Enrique Morales
Publication year - 2022
Publication title -
the nephron journals/nephron journals
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 72
eISSN - 2235-3186
pISSN - 1660-8151
DOI - 10.1159/000524201
Subject(s) - medicine , kidney disease , nonalcoholic fatty liver disease , renal function , proteinuria , obesity , glomerular hyperfiltration , population , intensive care medicine , nephrology , weight loss , disease , kidney , endocrinology , bioinformatics , fatty liver , diabetic nephropathy , environmental health , biology
Treatment for obesity in patients with CKD englobes a wide range of options, from lifestyle modification to bariatric surgery. Weight loss improves metabolic parameters and stimulates changes in renal function that lead to improvement of glomerular hyperfiltration. The most common clinical presentation is a slowly increasing non-nephrotic proteinuria that is followed by a progressive decline of kidney function. The use of multitarget therapies, with appropriate dietary education, emerging diets, the use of new RAAS blocking agents, the combination of iSGLT2 or GLP-1 agonists, as well as bariatric surgery, may play a key role in finally achieving the desired nephroprotection in this CKD population. New therapeutic agents and novel biomarkers, such as adipocyte cytokines, are needed to monitor and mitigate progression to end-stage renal disease. The emerging “lipidomics” and the role of nonalcoholic fatty liver are relevant research lines.