Obesity and Metabolic Health in CKD

Obesity is a worldwide epidemic with a future projected growth of 40% over ten years. Obesity increases the risk of diabetes, hypertension and cardiovascular disease, and it also leads to higher risk of chronic kidney disease, both through direct and indirect mechanisms. While obesity is a feature of over-nutrition and is associated with poor outcomes in the general population, obese individuals with chronic kidney disease often display complex metabolic patterns such as sarcopenic obesity, and obesity can be associated with better survival in individuals with advanced chronic kidney disease. Weight loss interventions are proven to improve glycemic control and cardiovascular risk factors, and successful weight loss is associated with improved albuminuria in patients with preexisting chronic kidney disease. The long term effects of weight loss interventions on kidney function and on survival in patients with chronic kidney disease are less well studied, and hence such interventions should be individualized.