S.E.N., SLANH, and SEEDO consensus report on obesity-related kidney disease: proposal for a new classification.

Abstract

Obesity-related chronic kidney disease (Ob-CKD) is an alteration that affects a wide variety of patients with chronic kidney disease (CKD) at different levels: without ultrastructural lesions (hyperfiltration and/or albuminuria), with obesity-related glomerulopathy (glomerular hypertrophy, podocytopathy, matrix mesangial expansion, focal and segmental glomerulosclerosis, tubular-interstitial fibrosis, vascular lesions, and tubular atrophy), associated with other kidney diseases, in persons with CKD in dialysis programs, as well as patients with transplanted kidneys. The S.E.N. (Sociedad Española de Nefrología), SLANH (Sociedad Latinoamericana de Nefrología e Hipertensión), and SEEDO (Sociedad Española para el Estudio de la Obesidad) Consensus report on Ob-CKD proposes a classification based on kidney alterations and CKD stage (CKD, dialysis, or kidney transplant) with the clear aim to unify nomenclature and subsequently the management of persons with Ob-CKD. The document defines a classification of Ob-CKD. As seen with current times in terms of new strategies for Ob-CKD treatment, the consensus also recognizes that an effective management of obesity in persons with CKD, when available, should be treated by a multidisciplinary team that incorporates nutrition, physical activity, pharmacotherapy, as well as bariatric surgery, if indicated. In addition, the consensus also mentioned the new therapeutic approach with incretin-based therapies that has demonstrated to decrease body weight and have a beneficial effect on cardiorenal events and reduction in cardiovascular death in patients with obesity and CKD.