Obesity is increasing among patients with glomerulonephritis (GN), and it is associated with progression to end-stage kidney disease (ESKD) in some subtypes, according to new study findings presented at Kidney Week 2021, a virtual meeting of the American Society of Nephrology.

In a study of 14,492 patients, obesity in glomerular disease (defined as a body mass index of 30 kg/m2 or higher) increased from 0.6% in 1979-1988 to 8.3% of patients in the most recent decade, 2009-2018, Se Won Oh, MD, PhD, of Korea University Medical Center in Seoul, and colleagues reported. In obese patients, IgA nephropathy (IgAN) was the most common type of glomerular disease (33.7%), followed by focal segmental glomerulosclerosis (FSGS; 13.3%), minimal change disease (MCD; 10.8%), membranous nephropathy (10.6%), diabetic nephropathy (6.0%), lupus nephritis (LN; 2.7%), and hypertensive nephropathy (2.6%). Obese patients had a significant 1.6-, 1.5, and 2.1-fold higher risk for FSGS, diabetic nephropathy, and hypertensive nephropathy, respectively, compared nonobese patients in adjusted analyses.

Obesity vs no obesity was significantly associated with a 2.5- and 3.3-fold increased risk for progression to ESKD in MCD and LN, respectively, but not in FSGS, diabetic nephropathy, or hypertensive nephropathy, Dr Oh and collaborators reported.


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In MCD only, obesity was significantly associated with a significant 6.5-fold increased risk for mortality.

“Obese MCD patients had decreased renal function and higher percentage of global sclerosis, and obese MCD and lupus nephritis patients had persistent proteinuria after diagnosis,” Dr Oh’s team noted.

Reference

Kim TB, Min HJ, Son YB, et al. The impact of obesity on glomerulonephritis: a multicenter cohort study of kidney biopsy over 40 years. Presented at: Kidney Week 2021; November 2-7, 2021. Presentation: PO1565.