1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

Obesity-Related Glomerulopathy

Isolated case reports and results of small series suggest the existence of obesity-related glomerulopathy (ORG), a condition unfamiliar to most clinicians. Researchers from Columbia University present what they call the "first large renal-biopsy-based clinicopathological study" of ORG.

ORG was defined as glomerulomegaly (glomerular enlargement) in a person with a body-mass index higher than 30 kg/m². During the past 14 years, 103 cases of ORG were diagnosed from 6818 renal biopsies submitted to the pathology laboratory; adequate clinical information was available for 71 patients (mean age, 43 years; mean BMI, 41.7 kg/m²). Of these, 14 patients had glomerulomegaly alone, and 57 had glomerulomegaly plus focal segmental glomerulosclerosis (FSGS). Mean serum creatinine was 1.5 mg/dL (range, 0.6 to 6.3), mean 24-hour urine protein was 4.1 g (range, 1 to 32 g), and mean serum albumin was 3.9 g/dL. Half the patients had nephrotic-range proteinuria, but only 6 percent had nephrotic syndrome (most patients had neither hypoalbuminemia nor edema). A comparison group of 50 patients with idiopathic FSGS was younger at presentation and had lower mean serum albumin (2.9 g/dL) and higher prevalence of nephrotic syndrome (54 percent) than did patients with ORG. During an average follow-up of 27 months, 2 ORG patients progressed to end-stage renal disease.

Comment: These researchers conclude that ORG is a distinct entity that may be increasing in prevalence. Its progression appears to be more indolent than that of FSGS. No systematic treatment protocol was instituted for these patients, but the authors note that proteinuria diminished in patients who lost substantial weight.

— AS Brett

Published in Journal Watch General Medicine April 27, 2001

Citation(s):

Kambham N et al. Obesity-related glomerulopathy: An emerging epidemic. Kidney Int 2001 Apr 59 1498-1509.

• Medline abstract (Free)