Range of adiposity and cardiorenal syndrome

被引:17
作者
Pazos, Fernando [1 ]
机构
[1] Cantabria Univ, Dept Med, Med Fac, Valdecilla Hosp, POB 2257, Santander 39080, Cantabria, Spain
关键词
Obesity; Morbid obesity; Cardiorenal syndrome; Heart failure; Chronic kidney disease; CHRONIC KIDNEY-DISEASE; DECOMPENSATED HEART-FAILURE; REDUCED EJECTION FRACTION; WORSENING RENAL-FUNCTION; BODY-MASS INDEX; ANGIOTENSIN-ALDOSTERONE SYSTEM; OBESITY-INDUCED HYPERTENSION; BASE-LINE CHARACTERISTICS; BARIATRIC SURGERY; WEIGHT-LOSS;
D O I
10.4239/wjd.v11.i8.322
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Obesity and obesity-related co-morbidities, diabetes mellitus, and hypertension are among the fastest-growing risk factors of heart failure and kidney disease worldwide. Obesity, which is not a unitary concept, or a static process, ranges from alterations in distribution to the amount of adiposity. Visceral adiposity, which includes intraabdominal visceral fat mass and ectopic fat deposition such as hepatic, cardiac, or renal, was robustly associated with a greater risk for cardiorenal morbidity than subcutaneous adiposity. In addition, morbid obesity has also demonstrated a negative effect on cardiac and renal functioning. The mechanisms by which adipose tissue is linked with the cardiorenal syndrome (CRS) are hemodynamic and mechanical changes, as well neurohumoral pathways such as insulin resistance, endothelial dysfunction, nitric oxide bioavailability, renin-angiotensin-aldosterone, oxidative stress, sympathetic nervous systems, natriuretic peptides, adipokines and inflammation. Adiposity and other associated co-morbidities induce adverse cardiac remodeling and interstitial fibrosis. Heart failure with preserved ejection fraction has been associated with obesity-related functional and structural abnormalities. Obesity might also impair kidney function through hyperfiltration, increased glomerular capillary wall tension, and podocyte dysfunction, which leads to tubulointerstitial fibrosis and loss of nephrons and, finally, chronic kidney disease. The development of new treatments with renal and cardiac effects in the context of type 2 diabetes, which improves mortality outcome, has highlighted the importance of CRS and its prevalence. Increased body fat triggers cellular, neuro-humoral and metabolic pathways, which create a phenotype of the CRS with specific cellular and biochemical biomarkers. Obesity has become a single cardiorenal umbrella or type of cardiorenal metabolic syndrome. This review article provides a clinical overview of the available data on the relationship between a range of adiposity and CRS, the support for obesity as a single cardiorenal umbrella, and the most relevant studies on the recent therapeutic approaches.
引用
收藏
页数:30
相关论文
共 200 条
[1]   Health Effects of Overweight and Obesity in 195 Countries over 25 Years [J].
Afshin, Ashkan ;
Forouzanfar, Mohammad H. ;
Reitsma, Marissa B. ;
Sur, Patrick ;
Estep, Kara ;
Lee, Alex ;
Marczak, Laurie ;
Mokdad, Ali H. ;
Moradi-Lakeh, Maziar ;
Naghavi, Mohsen ;
Salama, Joseph S. ;
Vos, Theo ;
Abate, Kalkidan H. ;
Abbafati, Cristiana ;
Ahmed, Muktar B. ;
Al-Aly, Ziyad ;
Alkerwi, Ala'a ;
Al-Raddadi, Rajaa ;
Amare, Azmeraw T. ;
Amberbir, Alemayehu ;
Amegah, Adeladza K. ;
Amini, Erfan ;
Amrock, Stephen M. ;
Anjana, Ranjit M. ;
Arnlov, Johan ;
Asayesh, Hamid ;
Banerjee, Amitava ;
Barac, Aleksandra ;
Baye, Estifanos ;
Bennett, Derrick A. ;
Beyene, Addisu S. ;
Biadgilign, Sibhatu ;
Biryukov, Stan ;
Bjertness, Espen ;
Boneya, Dube J. ;
Campos-Nonato, Ismael ;
Carrero, Juan J. ;
Cecilio, Pedro ;
Cercy, Kelly ;
Ciobanu, Liliana G. ;
Cornaby, Leslie ;
Damtew, Solomon A. ;
Dandona, Lalit ;
Dandona, Rakhi ;
Dharmaratne, Samath D. ;
Duncan, Bruce B. ;
Eshrati, Babak ;
Esteghamati, Alireza ;
Feigin, Valery L. ;
Fernandes, Joao C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (01) :13-27
[2]   Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial [J].
Agarwal, Rajiv ;
Rossignol, Patrick ;
Romero, Alain ;
Garza, Dahlia ;
Mayo, Martha R. ;
Warren, Suzette ;
Ma, Jia ;
White, William B. ;
Williams, Bryan .
LANCET, 2019, 394 (10208) :1540-1550
[3]   Heterogeneity of Cause, Care, and Prognosis in Severe Acute Kidney Injury in Hospitalized Patients: A Prospective Observational Study [J].
Aglae, Cedric ;
Muller, Laurent ;
Reboul, Pascal ;
Cariou, Sylvain ;
Davide, Barbar Saber ;
Trusson, Remi ;
Messikh, Ziyad ;
De Brauwere, David-Paul ;
Lefrant, Jean-Yves ;
Moranne, Olivier .
CANADIAN JOURNAL OF KIDNEY HEALTH AND DISEASE, 2019, 6
[4]   EFFECT OF WEIGHT-LOSS ON CARDIAC CHAMBER SIZE, WALL THICKNESS AND LEFT-VENTRICULAR FUNCTION IN MORBID-OBESITY [J].
ALPERT, MA ;
TERRY, BE ;
KELLY, DL .
AMERICAN JOURNAL OF CARDIOLOGY, 1985, 55 (06) :783-786
[5]   Visceral Adiposity Index A reliable indicator of visceral fat function associated with cardiometabolic risk [J].
Amato, Marco C. ;
Giordano, Carla ;
Galia, Massimo ;
Criscimanna, Angela ;
Vitabile, Salvatore ;
Midiri, Massimo ;
Galluzzo, Aldo .
DIABETES CARE, 2010, 33 (04) :920-922
[6]  
[Anonymous], 2016, Circulation: Heart Failure, DOI DOI 10.1161/CIRCHEARTFAILURE.115.002260
[7]   Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice [J].
Appel, Lawrence J. ;
Clark, Jeanne M. ;
Yeh, Hsin-Chieh ;
Wang, Nae-Yuh ;
Coughlin, Janelle W. ;
Daumit, Gail ;
Miller, Edgar R., III ;
Dalcin, Arlene ;
Jerome, Gerald J. ;
Geller, Steven ;
Noronha, Gary ;
Pozefsky, Thomas ;
Charleston, Jeanne ;
Reynolds, Jeffrey B. ;
Durkin, Nowella ;
Rubin, Richard R. ;
Louis, Thomas A. ;
Brancati, Frederick L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (21) :1959-1968
[8]   Cellular mechanisms underlying obesity-induced arterial stiffness [J].
Aroor, Annayya R. ;
Jia, Guanghong ;
Sowers, James R. .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 2018, 314 (03) :R387-R398
[9]   Design and Baseline Characteristics of the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease Trial [J].
Bakris, George L. ;
Agarwal, Rajiv ;
Anker, Stefan D. ;
Pitt, Bertram ;
Ruilope, Luis M. ;
Nowack, Christina ;
Kolkhof, Peter ;
Ferreira, Anna C. ;
Schloemer, Patrick ;
Filippatos, Gerasimos .
AMERICAN JOURNAL OF NEPHROLOGY, 2019, 50 (05) :333-344
[10]   Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy A Randomized Clinical Trial [J].
Bakris, George L. ;
Agarwal, Rajiv ;
Chan, Juliana C. ;
Cooper, Mark E. ;
Gansevoort, Ron T. ;
Haller, Hermann ;
Remuzzi, Giuseppe ;
Rossing, Peter ;
Schmieder, Roland E. ;
Nowack, Christina ;
Kolkhof, Peter ;
Joseph, Amer ;
Pieper, Alexander ;
Kimmeskamp-Kirschbaum, Nina ;
Ruilope, Luis M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (09) :884-894