Renal Disease in Patients with Severe Obesity

Obesity is associated with excess risk for impaired renal function (NEJM JW Gen Med Mar 1 2019 and BMJ 2019; 364:5301). This association is mediated in part by obesity-associated conditions such as diabetes and hypertension. However, obesity itself is thought to cause renal disease in some patients: Obesity-related glomerulopathy (ORG) is characterized by glomerular enlargement — with or without focal segmental glomerulosclerosis — and by substantial proteinuria (NEJM JW Gen Med May 15 2001 and Kidney Int 2001; 59:1498). In this report from Columbia University, researchers examined the spectrum of renal pathology in 239 patients with morbid obesity (body-mass index, ≥40 kg/m²) and clinical evidence of kidney disease who underwent renal biop…