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Cited by 187Blood Pressure and Hypertension StudiesRenin-Angiotensin System StudiesChronic Kidney Disease and Diabetes

Obesity-associated hypertension and kidney disease

Hall, John E., Kuo, Jay J., da Silva, Alexandre A., de Paula, Rogerio B., Liu, Jiankang, Tallam, Lakshmi·2003·Current Opinion in Nephrology and Hypertension
DOI 10.1097/00041552-200303000-00011
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Abstract

PURPOSE OF REVIEW: The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically during the past two decades. Our objective is to review the mechanisms that link obesity with hypertension and altered kidney function. RECENT FINDINGS: Current evidence suggests that excess weight gain may be responsible for 65-75% of the risk for essential hypertension. Abnormal renal pressure natriuresis, due initially to increased renal tubular sodium reabsorption, is a key factor linking obesity with hypertension. Obesity increases renal sodium reabsorption by activating the renin-angiotensin and sympathetic nervous systems, and by altering intrarenal physical forces. Adipose tissue functions as an endocrine organ, secreting hormones/cytokines (e.g. leptin) that may activate the sympathetic nervous system and alter kidney function. Excess visceral adipose tissue may physically compress the kidneys, increasing intrarenal pressures and tubular reabsorption. Sustained obesity eventually causes structural changes in the kidneys and loss of nephron function, further increasing arterial pressure and leading to severe renal disease in some cases. SUMMARY: Despite considerable progress in understanding the pathophysiology of obesity, there are still no specific guidelines for the treatment of obesity hypertension other than weight reduction. Special considerations for obese hypertensive patients, in addition to controlling blood pressure, are correcting the metabolic abnormalities and protecting the kidneys from injury. This remains an important area for further research, especially in view of the current 'epidemic' of obesity in most industrialized countries.

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Crossref · 10.1097/00041552-200303000-00011

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  • Obesity may lead to compression of the kidneys, resulting in increased intrarenal pressures and tending to reduce blood flow rates in the vasa recta and loop of Henle.

    “obesity may lead to compression of the kidneys, resulting in increased intrarenal pressures and tending to reduce blood flow rates in the vasa recta and loop of Henle35,45 (FIG. 2).”

    From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [45]

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Authors
Hall, J. E., Kuo, J. J., da Silva, A. A., de Paula, R. B., Liu, J., & Tallam, L.
Affiliations
University of Mississippi Medical Center (US)
Corresponding author
Hall, John E.
ORCID
Venue
Current Opinion in Nephrology and Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-03
Volume
12
Issue
2
Pages
195-200
ISSN
1062-4821 (ISSN-L)
DOI
10.1097/00041552-200303000-00011
OpenAlex
W2077179567
Cited by
187
References
32
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 8 · 2021: 10 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 11 · 2016: 7 · 2015: 7 · 2014: 14 · 2013: 14 · 2012: 7
FWCI
2.02
Type
journal article
Language
en
Open access
closed
Locations
  • Current Opinion in Nephrology & Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (P01-HL-51971, P01HL051971)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
obesity, obesity-related hypertension, essential hypertension, kidney disease, renal sodium reabsorption, renin-angiotensin system, sympathetic nervous system, adipose tissue hormones, leptin, visceral adipose tissue, intrarenal pressure, nephron function, weight loss
MeSH terms
Female, Humans, Hypertension, Kidney Diseases, Kidney Function Tests, Male, Obesity, Prognosis, Severity of Illness Index, Comorbidity, Incidence, Risk Assessment

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