Pathological influence of obesity on renal structural changes in chronic kidney disease.
BACKGROUND
Role of obesity in renal pathological and structural changes remains poorly investigated, and this study was designed to examine the pathological effects of obesity on renal structural components in patients with chronic kidney diseases (CKD).


METHODS
The study subjects were obese (body mass index, BMI > or = 25 kg/m2) patients with nonglomerulonephritis (non-GN, n = 26), IgA nephropathy (IgAN, n = 19), benign nephrosclerosis (BNS, n = 15), and thin basement membrane disease (TMD, n = 6), and 65 nonobese controls (n = 20, 20, 10, and 15, respectively). Patients were evaluated for glomerular lesions (mesangial proliferation and focal segmental/global glomerulosclerosis), glomerular size, and thickness of glomerular basement membrane (GBM).


RESULTS
Urinary protein was higher in obese non-GN, IgAN, and BNS groups than in the respective controls. Focal segmental glomerulosclerosis (FSGS) lesions were noted in all obesity groups. The glomeruli were larger in size in obese than in nonobese patients of the non-GN and IgAN groups. The glomeruli of nonobese TMD and BNS patients were significantly larger in size than those of nonobese non-GN patients. GBM were thicker in obese than in nonobese patients irrespective of types of glomerular diseases, but only significantly so in non-GN and BNS groups.


CONCLUSIONS
In non-GN, IgAN, and BNS, obesity worsens proteinuria and is associated with structural changes such as glomerulomegaly and GBM thickening, similar to changes observed in obesity-related nephropathy. Obesity seems to worsen the renopathological state in CKD.
Kato
Shigeko
S
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.|Department of Nutrition, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan.
Nazneen
Arifa
A
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Nakashima
Yumiko
Y
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Razzaque
Mohammed S
MS
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Nishino
Tomoya
T
Second Department of Internal Medicine, Nagasaki University School of Medicine and Dentistry, Nagasaki, Japan.
Furusu
Akira
A
Second Department of Internal Medicine, Nagasaki University School of Medicine and Dentistry, Nagasaki, Japan.
Yorioka
Noriaki
N
Department of Advanced Nephrology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Taguchi
Takashi
T
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. taguchi@nagasaki-u.ac.jp.
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D050533:Glomerular Basement Membrane / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000473:pathology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D009400:Nephrosclerosis / Q000150:complications / Q000473:pathology; D009765:Obesity / Q000150:complications* / Q000473:pathology; D011507:Proteinuria / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult