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中华肾病研究电子杂志 ›› 2016, Vol. 05 ›› Issue (01) : 38 -41. doi: 10.3877/cma.j.issn.2095-3216.2016.01.009

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综述

肥胖相关肾病发病机制与临床研究进展
吴睿1, 王锋1,(), 汪年松1,()   
  1. 1. 200233 上海交通大学附属第六人民医院肾脏科
  • 收稿日期:2015-09-14 出版日期:2016-02-28
  • 通信作者: 王锋, 汪年松
  • 基金资助:
    国家自然科学基金面上项目((81270824),(81570603))

Progress of pathogenesis and clinical research on obesity-related glomerulopathy

Rui Wu1, Feng Wang1,(), Niansong Wang1,()   

  1. 1. Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People′s Hospital, Shanghai 200233, China
  • Received:2015-09-14 Published:2016-02-28
  • Corresponding author: Feng Wang, Niansong Wang
  • About author:
    Corresponding author: Wang Feng, Email:
    Wang Niansong, Email:
引用本文:

吴睿, 王锋, 汪年松. 肥胖相关肾病发病机制与临床研究进展[J/OL]. 中华肾病研究电子杂志, 2016, 05(01): 38-41.

Rui Wu, Feng Wang, Niansong Wang. Progress of pathogenesis and clinical research on obesity-related glomerulopathy[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2016, 05(01): 38-41.

近20年来超重和肥胖人群迅猛增长,而由此诱发的肾脏损害-肥胖相关肾病(ORG)也越来越受到重视。ORG发病机制复杂,涉及血流动力学障碍、肾组织缺氧、胰岛素抵抗和交感神经过度激活等多种因素,而足细胞损伤在其中发挥核心作用。ORG病理形态包括两种:单纯肥胖相关性肾小球肥大和肥胖相关性局灶节段性肾小球硬化,患者最主要的临床特征是尽管有大量蛋白尿,但肾病综合征少见。治疗上主要针对患者的危险因素采取相应的干预措施,包括控制体重、改善胰岛素抵抗、抑制肾素血管紧张素醛固酮系统(RAAS)激活等,以期延缓肾功能恶化。

In the last 20 years, the population of overweight and obesity has been growing rapidly. And obesity-related glomerulopathy (ORG), which can be directly induced by obesity, has received more and more attention. The pathogenesis of ORG is complex, including hemodynamic dysfunction, kidney hypoxia, insulin resistance, over-activation of sympathetic nerve, and so on, in which podocyte injury appears to play a central role. The typical renal histologic features of ORG consisted of simple obesity-associated glomerular hypertrophy, and obesity- associated focal segmental glomerulosclerosis. The most striking clinical characteristic of ORG is the existence of massive proteinuria with very low incidence of nephrotic syndrome. The treatment for ORG mainly aims at the proper control of the associated risk factors, such as weight control, ameliorating insulin resistance, inhibiting over-activation of RAAS, etc, in order to delay the deterioration of renal functions.

1
Weisinger JR, Kempson RL, Eldridge FL, et al. The nephrotic syndrome: a complication of massive obesity [J]. Ann Intern Med, 1974, 81(4): 440-447.
2
Cohen AH. Massive obesity and the kidney. A morphologic and statistical study [J]. Am J Pathol, 1975, 81(1): 117-130.
3
王庆文. 肥胖相关性肾病的临床表现[J]. 肾脏病与透析肾移植志,2005,14(4): 343-344.
4
Kambham N, Markowitz GS, Valeri AM, et al. Obesity-related glomerulopathy: an emerging epidemic [J]. Kidney Int, 2001, 59(4): 1498-1509.
5
陈慧梅,刘志红,李世军,等. 肥胖相关性肾病患者流行病学资料及临床病理特征分析[J]. 肾脏病与透析肾移植杂志,2008,17(1): 30-37.
6
Darouich S, Goucha R, Jaafoura MH, et al. Clinicopathological characteristics of obesity-associated focal segmental glomerulosclerosis [J]. Ultrastruct Pathol, 2011, 35(4): 176-182.
7
Chagnac A, Weinstein T, Korzets A, et al. Glomerular hemodynamics in severe obesity [J]. Am J Physiol Renal Physiol, 2000, 278(5): F817-F822.
8
Durvasula RV, Petermann AT, Hiromura K, et al. Activation of a local tissue angiotensin system in podocytes by mechanical strain [J]. Kidney Int, 2004, 65(1): 30-39.
9
Yadav A, Vallabu S, Arora S, et al. ANG II promotes autophagy in podocytes [J]. Am J Physiol Cell Physiol, 2010, 299(2): C488-C496.
10
Lee H S. Mechanisms and consequences of TGF-ss overexpression by podocytes in progressive podocyte disease [J]. Cell Tissue Res, 2012, 347(1): 129-140.
11
Hoeppner LH, Phoenix KN, Clark K J, et al. Revealing the role of phospholipase Cbeta3 in the regulation of VEGF-induced vascular permeability [J]. Blood, 2012, 120(11): 2167-2173.
12
Friederich-Persson M, Thorn E, Hansell P, et al. Kidney hypoxia, attributable to increased oxygen consumption, induces nephropathy independently of hyperglycemia and oxidative stress [J]. Hypertension, 2013, 62(5): 914-919.
13
Serra A, Romero R, Lopez D, et al. Renal injury in the extremely obese patients with normal renal function [J]. Kidney Int, 2008, 73(8): 947-955.
14
Norman JT, Clark IM, Garcia PL. Hypoxia promotes fibrogenesis in human renal fibroblasts [J]. Kidney Int, 2000, 58(6): 2351-2366.
15
Eckardt KU, Bernhardt WM, Weidemann A, et al. Role of hypoxia in the pathogenesis of renal disease [J]. Kidney Int, 2005, 68(Suppl 99): S46-S51.
16
Welsh GI, Hale LJ, Eremina V, et al. Insulin signaling to the glomerular podocyte is critical for normal kidney function [J]. Cell Metab, 2010, 12(4): 329-340.
17
De Cosmo S, Menzaghi C, Prudente S, et al. Role of insulin resistance in kidney dysfunction: insights into the mechanism and epidemiological evidence [J]. Nephrol Dial Transplant, 2013, 28(1): 29-36.
18
范亚平,蒋季杰. 肥胖相关肾病[J]. 中华肾脏病杂志,2007,23(4): 267-270.
19
Sainz N, Barrenetxe J, Moreno-Aliaga MJ, et al. Leptin resistance and diet-induced obesity: central and peripheral actions of leptin [J]. Metabolism, 2015, 64(1): 35-46.
20
Nasrallah MP, Ziyadeh FN. Overview of the physiology and pathophysiology of leptin with special emphasis on its role in the kidney [J]. Semin Nephrol, 2013, 33(1): 54-65.
21
Wolf G, Ziyadeh FN. Leptin and renal fibrosis [J]. Contrib Nephrol, 2006, 151: 175-183.
22
Lambert EA, Straznicky NE, Dixon JB, et al. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? [J]. Am J Physiol Heart Circ Physiol, 2015, 309(2): H244-H258.
23
Redon J, Lurbe E. The kidney in obesity [J]. Curr Hypertens Rep, 2015, 17(6): 555.
24
Morales E, Valero MA, Leon M, et al. Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies [J]. Am J Kidney Dis, 2003, 41(2): 319-327.
25
Miyazaki Y, Cersosimo E, Triplitt C, et al. Rosiglitazone decreases albuminuria in type 2 diabetic patients [J]. Kidney Int, 2007, 72(11): 1367-1373.
26
Praga M, Hernandez E, Morales E, et al. Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis [J]. Nephrol Dial Transplant, 2001, 16(9): 1790-1798.
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