Chronic kidney disease (CKD) impacts over 37 million adults in the United States, with risk factors including diabetes, hypertension, atherosclerosis, and age, and shows notable racial disparities. CKD is linked to higher morbidity and mortality, often due to accelerated atherosclerotic vascular disease and acute coronary syndromes.

Obesity is now recognized as an independent risk factor for CKD, leading to obesity-related chronic kidney disease (ORCKD). ORCKD features altered renal hemodynamics, chronic inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system (RAAS). Primary ORCKD, where obesity is the main cause, is marked by glomerulomegaly and focal segmental glomerulosclerosis. Contributing factors include lipotoxicity, adipocytokine dysregulation, and glomerular hypertension. Early detection of renal injury markers like proteinuria is crucial. Effective management includes weight loss, RAAS inhibitors, and emerging treatments such as CD-36 inhibitors and SGLT-2 inhibitors. Early intervention and comprehensive treatment can improve outcomes and reduce the burden of ORCKD.

Reference: Ali MM, Parveen S, Williams V, Dons R, Uwaifo GI. Cardiometabolic comorbidities and complications of obesity and chronic kidney disease (CKD). J Clin Transl Endocrinol. 2024;36:100341. doi: 10.1016/j.jcte.2024.100341.