Clinicopathologic Findings in Obesity-related Glomerulopathy.
- Author:
Eun Kyung PARK
1
;
Yeong Seop YUN
;
Soon Hyo KWON
;
Jin Seok JEON
;
Hyun Jin NOH
;
Sun Young LEE
;
So Young JIN
;
Dong Cheol HAN
Author Information
1. Hyonam Kidney Laboratory, Soon Chun Hyang University College of Medicine, Seoul, Korea. handc@hosp.sch.ac.kr
- Publication Type:Original Article
- Keywords:
Obesity;
Glomerulosclerosis;
Focal segmental;
Nephrotic syndrome
- MeSH:
Arteriolosclerosis;
Atrophy;
Basement Membrane;
Blood Pressure;
Body Mass Index;
Edema;
Fibrosis;
Glomerulosclerosis, Focal Segmental;
Humans;
Nephrotic Syndrome;
Obesity;
Renal Insufficiency, Chronic;
Risk Factors;
Waist Circumference
- From:Korean Journal of Nephrology
2008;27(1):46-54
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Recently, obesity with metabolic syndrome is considered as an important risk factor in the development and progression of chronic kidney disease (CKD). Glomerulomegaly and focal segmental glomerulosclerosis (FSGS) are found in the obese patients, suggesting that investigation of structural- functional relationship in the obesity-related glomerulopathy (ORG) is needed to prevent CKD. Thus, we report here clinical and pathologic characteristics of ORG and its association with other clinical variables. METHODS: Obesity was defined by body mass index >25 kg/m2 and ORG morphologically by FSGS and glomerulomegaly or glomerulomegaly alone. Clinicopathologic findings and glomerular sizes of ORG (14 cases) were compared with age-matched controls with thin basement membrane disease. Multiple variable analysis was performed between glomerular size and clinical variables. RESULTS: There was no nephrotic syndrome or pretibial pitting edema in all obese patients. Mean glomerular diameter was increased in obese patients compared to controls (240+/-21 micrometer vs 197+/-21 micrometer, p=0.001). Seven cases had lesions with FSGS with glomerulomegaly and seven cases glomerulomegaly alone. Mild tubular atrophy, interstitial fibrosis and arteriolosclerosis were observed in more than half of patients. In obese patients, seven patients with FSGS had more elevated systolic blood pressure and tubular interstitial fibrosis compared to patients with glomerulomegaly only. Patients' systolic blood pressure and waist circumference were independent risk factors influencing the glomerular size in obese patients. CONCLUSION: FSGS or glomerulomegaly are prominent even in the mild obesity with insignificant clinical symptoms. This indicates that the clinical attention to glomerular disease is needed in obese patients.
