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Abstract：
BACKGROUND: The obesity epidemic is associated with the emergence of new kidney diseases including obesity-related glomerulopathy (ORG) and metabolic syndrome-associated disorders. However, the effects of obesity on prevalence and outcome of biopsy-proven kidney disease are not well known.
METHODS: We analyzed 14,492 kidney biopsies in 18 hospitals from 1979 to 2018 in Korea. Obesity was defined as a body mass index value of ≥ 30 kg/m².
RESULTS: The most common disease was IgA nephropathy (IgAN) in both obese and non-obese participants (33.7% vs. 38.9%). Obesity was associated with a higher risk of focal segmental glomerulosclerosis (FSGS) and hypertensive nephropathy (HT-N) (odds ratio [OR], 1.72, 95% confidence interval [CI], 1.37-2.17; OR, 1.96, 95% CI, 1.21-3.19) and a lower risk of IgAN (OR, 0.74, 95% CI, 0.62-0.88). During the median follow up of 93.1 ± 88.7 months, obesity increased the risk of end-stage kidney disease (ESKD) in patients with IgAN (relative risk [RR], 1.49, 95% CI, 1.01-2.20) and lupus nephritis (LN) (RR, 3.43, 95% CI, 1.36-8.67). Of 947 obese individuals, ORG was detected in 298 (31.5%), and 230 participants had other kidney diseases, most commonly, IgAN (40.9%) followed by diabetic nephropathy (15.2%). Participants with ORG, when combined with other renal diseases, showed higher risks for developing ESKD compared to those with ORG alone (RR, 2.48, 95% CI, 1.09-5.64).
CONCLUSIONS: Obesity is associated with an increased risk of FSGS and HT-N, and also increase the ESKD risk in IgAN and LN patients. ORG in obese participants may have favorable renal outcomes if it occurs alone without any other renal disease.
METHODS: We analyzed 14,492 kidney biopsies in 18 hospitals from 1979 to 2018 in Korea. Obesity was defined as a body mass index value of ≥ 30 kg/m².
RESULTS: The most common disease was IgA nephropathy (IgAN) in both obese and non-obese participants (33.7% vs. 38.9%). Obesity was associated with a higher risk of focal segmental glomerulosclerosis (FSGS) and hypertensive nephropathy (HT-N) (odds ratio [OR], 1.72, 95% confidence interval [CI], 1.37-2.17; OR, 1.96, 95% CI, 1.21-3.19) and a lower risk of IgAN (OR, 0.74, 95% CI, 0.62-0.88). During the median follow up of 93.1 ± 88.7 months, obesity increased the risk of end-stage kidney disease (ESKD) in patients with IgAN (relative risk [RR], 1.49, 95% CI, 1.01-2.20) and lupus nephritis (LN) (RR, 3.43, 95% CI, 1.36-8.67). Of 947 obese individuals, ORG was detected in 298 (31.5%), and 230 participants had other kidney diseases, most commonly, IgAN (40.9%) followed by diabetic nephropathy (15.2%). Participants with ORG, when combined with other renal diseases, showed higher risks for developing ESKD compared to those with ORG alone (RR, 2.48, 95% CI, 1.09-5.64).
CONCLUSIONS: Obesity is associated with an increased risk of FSGS and HT-N, and also increase the ESKD risk in IgAN and LN patients. ORG in obese participants may have favorable renal outcomes if it occurs alone without any other renal disease.
摘要：
背景：肥胖流行与新的肾脏疾病的出现有关，包括肥胖相关性肾小球病（ORG）和代谢综合征相关疾病。然而,肥胖对经活检证实的肾脏疾病的患病率和结局的影响尚不清楚.
方法：我们分析了1979年至2018年韩国18家医院的14,492例肾脏活检。肥胖定义为体重指数值≥30kg/m²。
结果：肥胖和非肥胖参与者中最常见的疾病是IgA肾病（IgAN）（33.7%vs.38.9%）。肥胖与局部节段肾小球硬化（FSGS）和高血压肾病（HT-N）的高风险相关（比值比[OR]，1.72，95%置信区间[CI]，1.37-2.17；或，1.96，95%CI，1.21-3.19）和较低的IgAN风险（OR，0.74，95%CI，0.62-0.88）。中位随访93.1±88.7个月,肥胖增加了IgAN患者终末期肾病(ESKD)的风险(相对风险[RR]，1.49，95%CI，1.01-2.20）和狼疮性肾炎（LN）（RR，3.43，95%CI，1.36-8.67）。在947名肥胖个体中，在298（31.5%）中检测到ORG，230名参与者患有其他肾脏疾病，最常见的是,IgAN(40.9%)其次是糖尿病肾病(15.2%)。ORG参与者,当与其他肾脏疾病合并时，与单独使用ORG的患者相比，出现ESKD的风险更高(RR，2.48，95%CI，1.09-5.64）。
结论：肥胖与FSGS和HT-N的风险增加有关，并增加IgAN和LN患者的ESKD风险。如果肥胖参与者的ORG单独发生而没有任何其他肾脏疾病，则可能具有良好的肾脏结局。
方法：我们分析了1979年至2018年韩国18家医院的14,492例肾脏活检。肥胖定义为体重指数值≥30kg/m²。
结果：肥胖和非肥胖参与者中最常见的疾病是IgA肾病（IgAN）（33.7%vs.38.9%）。肥胖与局部节段肾小球硬化（FSGS）和高血压肾病（HT-N）的高风险相关（比值比[OR]，1.72，95%置信区间[CI]，1.37-2.17；或，1.96，95%CI，1.21-3.19）和较低的IgAN风险（OR，0.74，95%CI，0.62-0.88）。中位随访93.1±88.7个月,肥胖增加了IgAN患者终末期肾病(ESKD)的风险(相对风险[RR]，1.49，95%CI，1.01-2.20）和狼疮性肾炎（LN）（RR，3.43，95%CI，1.36-8.67）。在947名肥胖个体中，在298（31.5%）中检测到ORG，230名参与者患有其他肾脏疾病，最常见的是,IgAN(40.9%)其次是糖尿病肾病(15.2%)。ORG参与者,当与其他肾脏疾病合并时，与单独使用ORG的患者相比，出现ESKD的风险更高(RR，2.48，95%CI，1.09-5.64）。
结论：肥胖与FSGS和HT-N的风险增加有关，并增加IgAN和LN患者的ESKD风险。如果肥胖参与者的ORG单独发生而没有任何其他肾脏疾病，则可能具有良好的肾脏结局。
