Skip to main content
Erschienen in: Clinical and Experimental Nephrology 3/2015

01.06.2015 | Original Article

The influences of larger physical constitutions including obesity on the amount of urine protein excretion in primary glomerulonephritis: research of the Japan Renal Biopsy Registry

verfasst von: Yuriko Yonekura, Shunsuke Goto, Hitoshi Sugiyama, Hiroshi Kitamura, Hitoshi Yokoyama, Shinichi Nishi

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

This study aimed to describe the influences of larger physical constitutions including obesity on the amount of urine protein excretion (AUPE) in primary glomerulonephritis. The distinct effects on the AUPE in various types of glomerulonephritis were evaluated.

Methods

Using the database of the Japan Renal Biopsy Registry (J-RBR) from 2007 to 2010, 4060 cases with primary glomerulonephritis including MCNS, FSGS, MN, MPGN, IgAN, and non-IgA were reviewed. The AUPEs were compared between high and low Body Mass Index (BMI) groups, and larger and smaller body surface area (BSA) groups using the indexes of BMI 25.0 kg/m2 and BSA 1.73 m2 in all cases and in each histological group. Multivariable analysis was performed to evaluate the predominant contributors to the AUPE.

Results

The larger physical constitution groups (BMI ≥25.0 kg/m2 or BSA ≥1.73 m2) had significantly higher AUPEs in all cases with primary glomerulonephritis. When compared in each histological group, the mean AUPEs were significantly higher in the larger physical constitution groups, excluding the FSGS and non-IgA groups. Multiple regression analysis revealed that the significant contributors to the AUPE were BMI and BSA in MCNS and MN, whereas BMI and BSA were not significant and mean blood pressure and serum creatinine were significant in FSGS and non-IgA.

Conclusion

Larger physical constitutions including obesity had a significant impact on the increase in the AUPE in primary glomerulonephritis, especially in MCNS and MN. However, FSGS and non-IgA were distinct for having blood pressure and renal dysfunction as possibly the major causes of proteinuria.
Literatur
1.
Zurück zum Zitat Wickman C, Kramer H. Obesity and kidney disease: potential mechanisms. Semin Nephrol. 2013;33:14–22.PubMedCrossRef Wickman C, Kramer H. Obesity and kidney disease: potential mechanisms. Semin Nephrol. 2013;33:14–22.PubMedCrossRef
2.
Zurück zum Zitat Ohashi Y, Otani T, Tai R, Okada T, Tanaka K, Tanaka Y, Sakai K, Aikawa A. Associations of proteinuria, fluid volume imbalance, and body mass index with circadian ambulatory blood pressure in chronic kidney disease patients. Kidney Blood Press Res. 2012;36:231–41.PubMedCrossRef Ohashi Y, Otani T, Tai R, Okada T, Tanaka K, Tanaka Y, Sakai K, Aikawa A. Associations of proteinuria, fluid volume imbalance, and body mass index with circadian ambulatory blood pressure in chronic kidney disease patients. Kidney Blood Press Res. 2012;36:231–41.PubMedCrossRef
3.
Zurück zum Zitat Tanaka M, Yamada S, Iwasaki Y, Sugishita T, Yonemoto S, Tsukamoto T, Fukui S, Takasu K, Muso E. Impact of obesity on IgA nephropathy: comparative ultrastructural study between obese and non-obese patients. Nephron Clin Pract. 2009;112:c71–8.PubMedCrossRef Tanaka M, Yamada S, Iwasaki Y, Sugishita T, Yonemoto S, Tsukamoto T, Fukui S, Takasu K, Muso E. Impact of obesity on IgA nephropathy: comparative ultrastructural study between obese and non-obese patients. Nephron Clin Pract. 2009;112:c71–8.PubMedCrossRef
4.
Zurück zum Zitat Woo KT, Chan CM, Mooi CY, L-Choong H, Tan HK, Foo M, Lee GS, Anantharaman V, Lim CH, Tan CC, Lee EJ, Chiang GS, Tan PH, Boon TH, Fook-Chong S, Wong KS. The changing pattern of primary glomerulonephritis in Singapore and other countries over the past 3 decades. Clin Nephrol. 2010;74:372–83.PubMedCrossRef Woo KT, Chan CM, Mooi CY, L-Choong H, Tan HK, Foo M, Lee GS, Anantharaman V, Lim CH, Tan CC, Lee EJ, Chiang GS, Tan PH, Boon TH, Fook-Chong S, Wong KS. The changing pattern of primary glomerulonephritis in Singapore and other countries over the past 3 decades. Clin Nephrol. 2010;74:372–83.PubMedCrossRef
5.
Zurück zum Zitat Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Kawamura T, Takeda T, Hataya H, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Shimizu A, Kitamura H, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Nagata M, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis and Committee for Kidney Disease Registry, Japanese Society of Nephrology, Japan. Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–73.PubMedCrossRef Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Kawamura T, Takeda T, Hataya H, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Shimizu A, Kitamura H, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Nagata M, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis and Committee for Kidney Disease Registry, Japanese Society of Nephrology, Japan. Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–73.PubMedCrossRef
6.
Zurück zum Zitat Matsushita Y, Takahashi Y, Mizoue T, Inoue M, Noda M, Tsugane S, JPHC Study Group. Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC Study. Int J Obes. 2008;32:1861–71.CrossRef Matsushita Y, Takahashi Y, Mizoue T, Inoue M, Noda M, Tsugane S, JPHC Study Group. Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC Study. Int J Obes. 2008;32:1861–71.CrossRef
7.
Zurück zum Zitat Yokoyama H, Taguchi T, Sugiyama H, Sato H, Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry in the Japanese Society of Nephrology. Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2012;16:557–63.PubMedCrossRef Yokoyama H, Taguchi T, Sugiyama H, Sato H, Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry in the Japanese Society of Nephrology. Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2012;16:557–63.PubMedCrossRef
8.
Zurück zum Zitat Alicic RZ, Patakoti R, Tuttle KR. Direct and indirect effects of obesity on the kidney. Adv Chronic Kidney Dis. 2013;20:121–7.PubMedCrossRef Alicic RZ, Patakoti R, Tuttle KR. Direct and indirect effects of obesity on the kidney. Adv Chronic Kidney Dis. 2013;20:121–7.PubMedCrossRef
9.
Zurück zum Zitat Kalaitzidis RG, Siamopoulos KC. The role of obesity in kidney disease: recent findings and potential mechanisms. Int Urol Nephrol. 2011;43:771–84.PubMedCrossRef Kalaitzidis RG, Siamopoulos KC. The role of obesity in kidney disease: recent findings and potential mechanisms. Int Urol Nephrol. 2011;43:771–84.PubMedCrossRef
10.
Zurück zum Zitat Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003;14:1480–6.PubMedCrossRef Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003;14:1480–6.PubMedCrossRef
11.
Zurück zum Zitat Hou CC, Shyu RS, Lee WJ, Ser KH, Lee YC, Chen SC. Improved renal function 12 months after bariatric surgery. Surg Obes Relat Dis. 2013;9:202–6.PubMedCrossRef Hou CC, Shyu RS, Lee WJ, Ser KH, Lee YC, Chen SC. Improved renal function 12 months after bariatric surgery. Surg Obes Relat Dis. 2013;9:202–6.PubMedCrossRef
12.
Zurück zum Zitat Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59:1498–509.PubMedCrossRef Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59:1498–509.PubMedCrossRef
13.
Zurück zum Zitat Hoy WE, Hughson MD, Zimanyi M, Samuel T, Douglas-Denton R, Holden L, Mott S, Bertram JF. Distribution of volumes of individual glomeruli in kidneys at autopsy: association with age, nephron number, birth weight and body mass index. Clin Nephrol. 2010;74:105–12. Hoy WE, Hughson MD, Zimanyi M, Samuel T, Douglas-Denton R, Holden L, Mott S, Bertram JF. Distribution of volumes of individual glomeruli in kidneys at autopsy: association with age, nephron number, birth weight and body mass index. Clin Nephrol. 2010;74:105–12.
14.
Zurück zum Zitat Darouich S, Goucha R, Jaafoura MH, Zekri S, Ben Maiz H, Kheder A. Clinicopathological characteristics of obesity-associated focal segmental glomerulosclerosis. Ultrastruct Pathol. 2011;35:176–82.PubMedCrossRef Darouich S, Goucha R, Jaafoura MH, Zekri S, Ben Maiz H, Kheder A. Clinicopathological characteristics of obesity-associated focal segmental glomerulosclerosis. Ultrastruct Pathol. 2011;35:176–82.PubMedCrossRef
15.
Zurück zum Zitat Praga M, Morales E. Obesity, proteinuria and progression of renal failure. Curr Opin Nephrol Hypertens. 2006;15:481–6.PubMedCrossRef Praga M, Morales E. Obesity, proteinuria and progression of renal failure. Curr Opin Nephrol Hypertens. 2006;15:481–6.PubMedCrossRef
17.
Zurück zum Zitat Ezequiel DG, Costa MB, Chaoubah A, de Paula RB. Weight loss improves renal hemodynamics in patients with metabolic syndrome. Bras Nefrol. 2012;34:36–42. Ezequiel DG, Costa MB, Chaoubah A, de Paula RB. Weight loss improves renal hemodynamics in patients with metabolic syndrome. Bras Nefrol. 2012;34:36–42.
18.
Zurück zum Zitat Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S. Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr. 2002;11:S732–7.CrossRef Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S. Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr. 2002;11:S732–7.CrossRef
19.
Zurück zum Zitat Harada H, Omura K. Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: phase trial. J Exp Clin Cancer Res. 2010;29:33.PubMedCentralPubMedCrossRef Harada H, Omura K. Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: phase trial. J Exp Clin Cancer Res. 2010;29:33.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Fujita K, Ichikawa W. Yamamoto. Fixed dosing and pharmacokinetics of S-1 in Japanese cancer patients with large body surface areas. Ann Oncol. 2009;20:946–9.PubMedCrossRef Fujita K, Ichikawa W. Yamamoto. Fixed dosing and pharmacokinetics of S-1 in Japanese cancer patients with large body surface areas. Ann Oncol. 2009;20:946–9.PubMedCrossRef
21.
Zurück zum Zitat Siddall EC, Radhakrishnan J. The pathophysiology of edema formation in the nephrotic syndrome. Kidney Int. 2012;82:635–42.PubMedCrossRef Siddall EC, Radhakrishnan J. The pathophysiology of edema formation in the nephrotic syndrome. Kidney Int. 2012;82:635–42.PubMedCrossRef
22.
Zurück zum Zitat Bockenhauer D. Over- or underfill: not all nephrotic states are created equal. Pediatr Nephrol. 2013;28(8):1153–6.PubMedCrossRef Bockenhauer D. Over- or underfill: not all nephrotic states are created equal. Pediatr Nephrol. 2013;28(8):1153–6.PubMedCrossRef
23.
Zurück zum Zitat Woo KT, Chiang GS, Pall A, Tan PH, Lau YK, Chin YM. The changing pattern of glomerulonephritis in Singapore over the past two decades. Clin Nephrol. 1999;52:96–102.PubMed Woo KT, Chiang GS, Pall A, Tan PH, Lau YK, Chin YM. The changing pattern of glomerulonephritis in Singapore over the past two decades. Clin Nephrol. 1999;52:96–102.PubMed
24.
Zurück zum Zitat de Mik SM, Hoogduijn MJ, de Bruin RW, Dor FJ. Pathophysiology and treatment of focal segmental glomerulosclerosis: the role of animal models. BMC Nephrol. 2013;14:74.PubMedCentralPubMedCrossRef de Mik SM, Hoogduijn MJ, de Bruin RW, Dor FJ. Pathophysiology and treatment of focal segmental glomerulosclerosis: the role of animal models. BMC Nephrol. 2013;14:74.PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat D’Agati VD, Fogo AB, Bruijn JA, Jennette JC. Pathologic classification of focal segmental glomerulosclerosis: a working proposal. Am J Kidney Dis. 2004;14:368–82.CrossRef D’Agati VD, Fogo AB, Bruijn JA, Jennette JC. Pathologic classification of focal segmental glomerulosclerosis: a working proposal. Am J Kidney Dis. 2004;14:368–82.CrossRef
Metadaten
Titel
The influences of larger physical constitutions including obesity on the amount of urine protein excretion in primary glomerulonephritis: research of the Japan Renal Biopsy Registry
verfasst von
Yuriko Yonekura
Shunsuke Goto
Hitoshi Sugiyama
Hiroshi Kitamura
Hitoshi Yokoyama
Shinichi Nishi
Publikationsdatum
01.06.2015
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 3/2015
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-014-0993-y

Weitere Artikel der Ausgabe 3/2015

Clinical and Experimental Nephrology 3/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.