Chronic kidney disease and obesity - pathomechanisms and treatment – literature review

Introduction and Objective. Chronic kidney disease (CKD) is a major health issue worldwide affecting 10–14% of the globe’s population, with a climbing trend. CKD is associated with a variety of factors, including obesity, which has grown increasingly prevalent and adds to the pathogenesis of the disease. The aim of the review is to summarise pathomechanism and current treatment methods of chronic kidney disease. Additionally, using this knowledge, treatment suggestions are provided for different patient groups. Review Methods. A literature search was conducted in the PubMed database with inclusion criteria ‘English language’ and ‘free full texts’, and publications date between 2018 – 2023. A total of 1,172 results were found; 28 publications were ultimately included in the review. Brief description of the state of knowledge. The pathomechanisms include haemodynamic changes, oxidative stress, adipokine dysregulation, and correlations to insulin resistance and diabetes. Weight loss by proper nutrition and exercise is a beneficial approach to manage CKD in obese patients. Bariatric surgery has proven a realistic alternative due to improvements in kidney function and obesity-related comorbidities. There are several options for pharmacotherapy in CKD and obesity, including SGLT2 inhibitors, GLP-1 analogues, agents targeting the renin-angiotensin-aldosterone system and bardoxolone methyl. Addressing obesity plays an essential role in alleviating CKD risk and progression. Conclusions. Early intervention involving lifestyle changes, weight reduction strategies, surgical procedures, and medication provides a holistic approach to addressing CKD in obese people. Recognizing the complex interplay of variables that contribute to CKD enables targeted therapy approaches and better patient outcomes.