Abstract

Obesity poses a significant and growing risk factor for chronic kidney disease (CKD), requiring comprehensive evaluation and management strategies. This review explores the intricate relationship between obesity and CKD, emphasizing the diverse phenotypes of obesity, including sarcopenic obesity and metabolically healthy versus unhealthy obesity, and their differential impact on kidney function. We discuss the epidemiological evidence linking elevated body mass index (BMI) with CKD risk while also addressing the paradoxical survival benefits observed in obese CKD patients. Various measures of obesity, such as BMI, waist circumference, and visceral fat assessment, are evaluated in the context of CKD progression and outcomes. Mechanistic insights into how obesity promotes renal dysfunction through lipid metabolism, inflammation, and altered renal hemodynamics are elucidated, underscoring the role of adipokines and the renin-angiotensin-aldosterone system. Furthermore, the review examines current strategies for assessing kidney function in obese individuals, including the strengths and limitations of filtration markers and predictive equations. The management of obesity and associated comorbidities like arterial hypertension, type 2 diabetes mellitus, and non-alcoholic fatty liver disease in CKD patients is discussed. Finally, gaps in the current literature and future research directions aimed at optimizing the management of obesity-related CKD are highlighted, emphasizing the need for personalized therapeutic approaches to mitigate the growing burden of this intertwined epidemic.

MeSH

Diabetes Mellitus, Kidney Diseases, Glomerular Filtration Rate, Kidney, Adiposity, Obesity, Diabetes Mellitus, Type 2

Cited by

• Osteosarcopenia in Chronic Kidney Disease: An Overlooked Syndrome? J Cachexia Sarcopenia Muscle, 2025
• Obesity as a Risk Factor for Hyperglycemia, Electrolyte Disturbances, and Acute Kidney Injury in the Emergency Department. Biomedicines, 2025
• Global, regional, and national burdens of chronic kidney disease attributable to high body mass index from 1990 to 2021, with future forecasts up to 2050: a systematic analysis for the global burden of disease study 2021. Front Public Health, 2025
• Obesity Class and Severity of Metabolic Emergencies: A Single-Center Retrospective Five-Year Study. Healthcare (Basel), 2025
• Correlation between conventional and unconventional lipid parameters with the risk of progression of renal function decline: insights from the China Health and Retirement Longitudinal Study 2011-2015. Ren Fail, 2025