The relationship between obesity and the risk of progression of chronic kidney disease in patients with type 2 diabetes and methods of treatment

Abstract

Diabetic nephropathy is one of the main and most important causes of end-stage renal disease. The increase in the incidence of diabetes correlates with worldwide epidemic of obesity, which, together with hypertension and other elements of the metabolic syndrome affects an increased risk of cardiovascular complications compounded by a progressive decline in glomerular filtration rate. Daily medical practice shows that clinical diagnosis of diabetic nephropathy is preceded by an increase in glomerular filtration rate, the presence of microalbuminuria and glomerular hypertrophy. Poor glycemic control, elevated blood pressure exacerbate proteinuria and renal injury up to an irreversible end-stage renal disease. A similar sequence of events occurs in obese, non-diabetic patients. Therefore, prevention and treatment of obesity in people with diabetes is a key element inhibiting progression of kidney disease and it is as important as striving to fulfill the criteria for compensation of carbohydrate metabolism. The paper presents the impact of obesity on the progression of chronic kidney disease in people with type 2 diabetes and methods of treatment: nonpharmacological, pharmacological and surgical.