Interaction of aldosterone and extracellular volume in the pathogenesis of obesity-associated kidney disease: a narrative review.
Obesity and obesity-associated kidney injuries have played an important role in the rising prevalence of chronic kidney disease (CKD). The link between obesity and kidney disease begins with obesity's well-known associations with diabetes and hypertension, the two leading etiologies of CKD. However, a growing body of evidence suggests that elevated aldosterone levels and expanded extracellular volume are key components of obesity-induced renal disease via aldosterone's non-epithelial effects on the kidney. Highlighting these blood pressure- and diabetes-independent mechanisms of kidney injury in obesity allows an exploration of whether mineralocorticoid receptor blockade, coupled with weight loss and salt restriction, is an optimal treatment for overweight CKD patients.
Bomback
Andrew S
AS
UNC Kidney Center, Department of Medicine, Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7155, USA. abomback@unch.unc.edu
Klemmer
Philip J
PJ
D000450:Aldosterone / Q000378:metabolism*; D000818:Animals; D048909:Diabetes Complications / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000150:complications; D007333:Insulin Resistance; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications*; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009765:Obesity / Q000097:blood* / Q000150:complications*; D012492:Salts / Q000494:pharmacology; D015431:Weight Loss
D000451:Mineralocorticoid Receptor Antagonists; D012492:Salts; D000450:Aldosterone