nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1536Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESМеханизмы прогрессирования поражения почек при ожирении (Обзор литературы)Mechanisms of progression of kidney injury in obesityФедороваЕ. Ю.FedorovaE. U.noemail@neicon.ruКутыринаИ. М.KutyrinaI. M.noemail@neicon.ruКафедра нефрологии и гемодиализа ФППО, ММА им. И.М. Сеченова, г. МоскваRussian Federation20062306202582102111Copyright © Федорова Е.Ю., Кутырина И.М., 20252025Федорова Е.Ю., Кутырина И.М.Fedorova E.U., Kutyrina I.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1536

Ожирение является одной из основных проблем современного общества [4, 38, 81]. Показано, что наличие избыточной массы тела значимо уменьшает продолжительность жизни, а в двух из трех случаях смерть человека наступает от заболевания, ассоциированного с нарушением липидного обмена и избыточным весом [40]. В настоящее время ожирение рассматривают в качестве фактора риска развития тяжелых хронических заболеваний, таких как сахарный диабет 2 типа (СД 2), болезни сердца и сосудов, в том числе артериальной гипертонии (АГ) и ишемической болезни сердца (ИБС) [1, 7, 21, 23, 26, 75, 104], распространенность которых возрастает с каждым годом.

ожирениелептинренин-ангиотнензиновая системавнутриклубочковая гипертензияReferencesАметов А.С. Факторы риска сахарного диабета. Роль ожирения. Русский медицинский журнал 2003; 11; 27: 1477-1480.Аметов А.С. Факторы риска сахарного диабета. Роль ожирения. Русский медицинский журнал 2003; 11; 27: 1477-1480.Бутрова С.А. Метаболический синдром: патогенез, клиника, диагностика, подходы к лечению. Русский медицинский журнал 2001; 9; 2: 56-62.Бутрова С.А. Метаболический синдром: патогенез, клиника, диагностика, подходы к лечению. Русский медицинский журнал 2001; 9; 2: 56-62.Бутрова С.А., Дзгоева Ф.Х. Висцеральное ожирение - ключевое звено метаболического синдрома. Ожирение и метаболизм 2004; 1: 10-16.Бутрова С.А., Дзгоева Ф.Х. Висцеральное ожирение - ключевое звено метаболического синдрома. Ожирение и метаболизм 2004; 1: 10-16.Гинзбург М.М., Козлупица Г.С. Значение распределения жира при ожирении. Проблемы эндокринологии 1996; 42;.3: 42-46.Гинзбург М.М., Козлупица Г.С. Значение распределения жира при ожирении. Проблемы эндокринологии 1996; 42;.3: 42-46.Дедов И.И., Бутрова С.А., Воронцов А.В., Плохая А.А. Влияние висцеральной жировой ткани на гормонально-метаболические показатели при абдоминальном ожирении артериальной гипертонии. Ожирение и метаболизм 2004; 1: 26-29.Дедов И.И., Бутрова С.А., Воронцов А.В., Плохая А.А. Влияние висцеральной жировой ткани на гормонально-метаболические показатели при абдоминальном ожирении артериальной гипертонии. Ожирение и метаболизм 2004; 1: 26-29.Дедов И.И., Мельниченнко Г.А., Романцова Т.И. Патогенетические аспекты ожирения. Ожирение и метаболизм 2004; 1: 3-9.Дедов И.И., Мельниченнко Г.А., Романцова Т.И. Патогенетические аспекты ожирения. Ожирение и метаболизм 2004; 1: 3-9.Дедов И.И., Сунцов Ю.И., Кудрякова С.В. Эпидемиология сахарного диабета. В кн.: Сахарный диабет. Руководство для врачей. М.: Универсум паблишинг 2003: 75-93.Дедов И.И., Сунцов Ю.И., Кудрякова С.В. Эпидемиология сахарного диабета. В кн.: Сахарный диабет. Руководство для врачей. М.: Универсум паблишинг 2003: 75-93.Дедов И.И., Шестакова М.В. Диабетическая нефропатия М.: 2000.Дедов И.И., Шестакова М.В. Диабетическая нефропатия М.: 2000.Десперс Ж.-П. Оптимальное предупреждение коронарного риска у больных с висцеральным ожирением и дислипидемией. 10th European Congress on Obesity, May 2000. Ожирение. Актуальные вопросы 2001; 5: 6-8.Десперс Ж.-П. Оптимальное предупреждение коронарного риска у больных с висцеральным ожирением и дислипидемией. 10th European Congress on Obesity, May 2000. Ожирение. Актуальные вопросы 2001; 5: 6-8.Диденко В.А. Метаболический синдром Х: история вопроса и этиопатогенез. Лабораторная медицина 1999; 2: 49-56.Диденко В.А. Метаболический синдром Х: история вопроса и этиопатогенез. Лабораторная медицина 1999; 2: 49-56.Кобалава Ж.Д., Дмитрова Т.Б. Кардио-ренальный синдром. Русский медицинский журнал 2003; 11; 12: 699-703.Кобалава Ж.Д., Дмитрова Т.Б. Кардио-ренальный синдром. Русский медицинский журнал 2003; 11; 12: 699-703.Краснова Е.А., Моисеев С.В., Фомин В.В. Нефрологические аспекты проблемы ожирения. Клиническая медицина 2005; 4: 9-14.Краснова Е.А., Моисеев С.В., Фомин В.В. Нефрологические аспекты проблемы ожирения. Клиническая медицина 2005; 4: 9-14.Медведева Т.Ю. Влияние препаратов, блокирующих ренин-ангиотензиновую систему, на прогрессирование почечной недостаточности в клинике и эксперименте. Диссертация на соискание ученой степени кандидата медицинских наук. М.: 2001.Медведева Т.Ю. Влияние препаратов, блокирующих ренин-ангиотензиновую систему, на прогрессирование почечной недостаточности в клинике и эксперименте. Диссертация на соискание ученой степени кандидата медицинских наук. М.: 2001.Мухин Н.А., Моисеев В.С., Кобалава Ж.Д., Моисеев С.В., Фомин В.В. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек. Тер. архив 2004; 6: 39-47.Мухин Н.А., Моисеев В.С., Кобалава Ж.Д., Моисеев С.В., Фомин В.В. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек. Тер. архив 2004; 6: 39-47.Мухин Н.А., Балкаров И.М., Моисеев С.В. и соавт. Хронические прогрессирующие нефропатии и образ жизни современного человека. Тер. архив 2004; 9: 5-11.Мухин Н.А., Балкаров И.М., Моисеев С.В. и соавт. Хронические прогрессирующие нефропатии и образ жизни современного человека. Тер. архив 2004; 9: 5-11.Оганов Р.Г., Александров А.А. Гиперинсулинемия и артериальная гипертония: возвращаясь к выводам United Kingdom Prospective Diabetes Study. Русский медицинский журнал 2001; 7; 3: 6-10.Оганов Р.Г., Александров А.А. Гиперинсулинемия и артериальная гипертония: возвращаясь к выводам United Kingdom Prospective Diabetes Study. Русский медицинский журнал 2001; 7; 3: 6-10.Оконова Е.Б. Влияние блокады ренин-ангиотензиновой системы на протеинурию и темп прогрессирования хронического гломерулонефрита. Диссертация на соискание ученой степени кандидата медицинских наук. М.: 2001.Оконова Е.Б. Влияние блокады ренин-ангиотензиновой системы на протеинурию и темп прогрессирования хронического гломерулонефрита. Диссертация на соискание ученой степени кандидата медицинских наук. М.: 2001.Петеркова В.А., Ремизов О.В. Ожирение в детском возрасте. Ожирение и метаболизм 2004; 1: 17-23.Петеркова В.А., Ремизов О.В. Ожирение в детском возрасте. Ожирение и метаболизм 2004; 1: 17-23.Профилактика, диагностика и лечение первичной артериальной гипертонии в Российской Федерации (ДАГ-1). Клиническая фармакология и терапия. 2000; 9; 3: 1-24.Профилактика, диагностика и лечение первичной артериальной гипертонии в Российской Федерации (ДАГ-1). Клиническая фармакология и терапия. 2000; 9; 3: 1-24.Тареева И.Е. Механизмы прогрессирования гломерулонефрита. Тер. архив 1996; 6: 5-10.Тареева И.Е. Механизмы прогрессирования гломерулонефрита. Тер. архив 1996; 6: 5-10.Шарма A.M. Ожирение и риск сердечно-сосудистых заболеваний: новые аспекты. 10th European Congress on Obesity, May 2000. Ожирение. Актуальные вопросы 2001; 5: 4-6.Шарма A.M. Ожирение и риск сердечно-сосудистых заболеваний: новые аспекты. 10th European Congress on Obesity, May 2000. Ожирение. Актуальные вопросы 2001; 5: 4-6.Шестакова М.В., Дедов И.И., Шереметьева О.В., Ивлева А.Я. Показания к применению эналаприла при диабетической нефропатии. Клин. фармакология и терапия 1993; 3: 22-26.Шестакова М.В., Дедов И.И., Шереметьева О.В., Ивлева А.Я. Показания к применению эналаприла при диабетической нефропатии. Клин. фармакология и терапия 1993; 3: 22-26.Шилов А.М., Чубаров М.В., Мельник М.В., Рыбкина Т.Е. Артериальная гипертензия и метаболический синдром Х. Русский медицинский журнал 2003; 11; 21: 1145-1150.Шилов А.М., Чубаров М.В., Мельник М.В., Рыбкина Т.Е. Артериальная гипертензия и метаболический синдром Х. Русский медицинский журнал 2003; 11; 21: 1145-1150.Adult Treatment Panel III. JAMA 2001; 285: 2486-2497.Adult Treatment Panel III. JAMA 2001; 285: 2486-2497.Allessi M.C., Peiretti F., Morange P. et al. Production of plasminogen activator inghibitor-1 by human adipose tissue: possible link between visceral fat accumulation and vascular disease. Diabetes 1997; 46: 860-867.Allessi M.C., Peiretti F., Morange P. et al. Production of plasminogen activator inghibitor-1 by human adipose tissue: possible link between visceral fat accumulation and vascular disease. Diabetes 1997; 46: 860-867.Alpert M.A., Terry B.E., Mulekar M. et al. Cardiac morphology and left ventricular function in normotensive morbidly obese patients with and without congestive heart failure and effect of weight loss. Am J Cardiol 1997; 80: 736-740.Alpert M.A., Terry B.E., Mulekar M. et al. Cardiac morphology and left ventricular function in normotensive morbidly obese patients with and without congestive heart failure and effect of weight loss. Am J Cardiol 1997; 80: 736-740.Bailey R.R., Lynn K.L., Burry A.F., Drennan C. Proteinuria, glomerulomegaly and focal segmental glomerulosclerosis in a grossly obese man with obstructive sleep apnea syndrome. Aust N Z J Med 1989; 10: 470-472.Bailey R.R., Lynn K.L., Burry A.F., Drennan C. Proteinuria, glomerulomegaly and focal segmental glomerulosclerosis in a grossly obese man with obstructive sleep apnea syndrome. Aust N Z J Med 1989; 10: 470-472.Bard K.F., Murray J.J., Breyer M.D. et al. Mesangial cells, glomerular and renal vascular responses to endothelin in the rat kidney. J Clin Invest 1989; 83: 708-712.Bard K.F., Murray J.J., Breyer M.D. et al. Mesangial cells, glomerular and renal vascular responses to endothelin in the rat kidney. J Clin Invest 1989; 83: 708-712.Baud L., Fouqueray B., Amrani P.C. Tumor necrosis factor alpha and mesangial cells. Kidney Int 1992; 41: 600-603.Baud L., Fouqueray B., Amrani P.C. Tumor necrosis factor alpha and mesangial cells. Kidney Int 1992; 41: 600-603.Benigni A., Zoja C., Corna D. et al. A specific endothelin subtype A receptor antagonist protects against injury in renal disease progression. Kidney Int 1993; 44: 440-444.Benigni A., Zoja C., Corna D. et al. A specific endothelin subtype A receptor antagonist protects against injury in renal disease progression. Kidney Int 1993; 44: 440-444.Bohle A. Change of paradigms in nephrology - a view back and a look forward. Nephrol Dial Transpl 1998; 13: 556-563.Bohle A. Change of paradigms in nephrology - a view back and a look forward. Nephrol Dial Transpl 1998; 13: 556-563.Bonnet F., Deprele C., Sassolas A. et al. Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA-nephritis. Am J Kidney Dis 2001; 37; 4: 720-727.Bonnet F., Deprele C., Sassolas A. et al. Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA-nephritis. Am J Kidney Dis 2001; 37; 4: 720-727.Brenner B.M. Remission of renal disease: recounting the challenge, acquiring the goal. J Clin Invest 2002; 110: 1753-1758.Brenner B.M. Remission of renal disease: recounting the challenge, acquiring the goal. J Clin Invest 2002; 110: 1753-1758.Brenner B.M., Lawler E.V., Mackenzie H.S. The hyperfiltration theory: A paradigm shift in nephrology. Kidney Int 1996; 49: 1774-1777.Brenner B.M., Lawler E.V., Mackenzie H.S. The hyperfiltration theory: A paradigm shift in nephrology. Kidney Int 1996; 49: 1774-1777.Brink M., Wellen J., Delafontaine P. Ang II causes weight loss and decreases circulating insulin-like growth factor I in rats through a pressor-independent mechanism. J Clin Invest 1996; 97: 2509-2516.Brink M., Wellen J., Delafontaine P. Ang II causes weight loss and decreases circulating insulin-like growth factor I in rats through a pressor-independent mechanism. J Clin Invest 1996; 97: 2509-2516.Brocco E., Fioretto P., Mauer M. et al. Renal structure and function in non-insulin-dependent diabetic patients with microalbuminuria. Kidney Int 1997; 52; [Suppl 63]: S40-S44.Brocco E., Fioretto P., Mauer M. et al. Renal structure and function in non-insulin-dependent diabetic patients with microalbuminuria. Kidney Int 1997; 52; [Suppl 63]: S40-S44.Bruns K.D., Homma T., Harris R.C. The intrarenal rennin-angiotensin system. Semin Nephrol 1993; 13: 13-30.Bruns K.D., Homma T., Harris R.C. The intrarenal rennin-angiotensin system. Semin Nephrol 1993; 13: 13-30.Buckland Y. The obesity epidemic. J Fam Heaith Care 2002; 12; 4: 111.Buckland Y. The obesity epidemic. J Fam Heaith Care 2002; 12; 4: 111.Burton C.J., Harris K.P.G. The role of proteinuria in progression of chronic renal failure. Am J Kidney Dis. 1996; 27; 6: 765-775.Burton C.J., Harris K.P.G. The role of proteinuria in progression of chronic renal failure. Am J Kidney Dis. 1996; 27; 6: 765-775.Calle E., Thun M., Petrelli J. et al. Body-mass index and mortality in a prospective cohort of U.S. adults. B Engl J Med 1999; 341; 15: 1097-1105.Calle E., Thun M., Petrelli J. et al. Body-mass index and mortality in a prospective cohort of U.S. adults. B Engl J Med 1999; 341; 15: 1097-1105.Campbell D.J., Duncan A.M., Kladis A., Harrap S.B. Converting enzyme inhibition and its withdrawal in spontaneously hypertensive rats. J Cardiovasc Pharmacol 1995; 26: 426-436.Campbell D.J., Duncan A.M., Kladis A., Harrap S.B. Converting enzyme inhibition and its withdrawal in spontaneously hypertensive rats. J Cardiovasc Pharmacol 1995; 26: 426-436.Chade A.R., Rodriguez-Porcel M., Grande J.P. et al. Mechanisms of renal structural alterations in combined hypercholesterolemia and renal artery stenosis. Arteriosclerosis, Thrombosis, and Vascular Biology 2003; 23: 1295.Chade A.R., Rodriguez-Porcel M., Grande J.P. et al. Mechanisms of renal structural alterations in combined hypercholesterolemia and renal artery stenosis. Arteriosclerosis, Thrombosis, and Vascular Biology 2003; 23: 1295.Chen J., Munter P., Lee Hamm L. et al. Insulin resistance and risk of chronic Kidney disease in nondiabetic US adults. J Am Soc Nephrol 2003; 14: 469-477.Chen J., Munter P., Lee Hamm L. et al. Insulin resistance and risk of chronic Kidney disease in nondiabetic US adults. J Am Soc Nephrol 2003; 14: 469-477.Cortes P., Riser B., Narins R.G. Glomerular hypertension and progressive renal disease: The interplay of mesangial cell stretch, cytokine formation and extracellular matrix synthesis. Contrib Nephrol 1996; 118: 229-233.Cortes P., Riser B., Narins R.G. Glomerular hypertension and progressive renal disease: The interplay of mesangial cell stretch, cytokine formation and extracellular matrix synthesis. Contrib Nephrol 1996; 118: 229-233.Das U. Is obesity an inflammatory condition? Nutrition 2001; 17: 953-956.Das U. Is obesity an inflammatory condition? Nutrition 2001; 17: 953-956.De Simone G., Devereux R.B. et al. Relation of obesity and gender to left ventricular hypertrophy in normotensive and hypertensive adults. Hypertension 1994; 23: 600-606.De Simone G., Devereux R.B. et al. Relation of obesity and gender to left ventricular hypertrophy in normotensive and hypertensive adults. Hypertension 1994; 23: 600-606.Dengel D.R., Glodberg A.P., Mayuga R.S., Kairis G.M., Weir M.R. Insulin resistance, elevated glomerular filtration fraction, and renal injury. Hypertension 1996; 28: 127-132.Dengel D.R., Glodberg A.P., Mayuga R.S., Kairis G.M., Weir M.R. Insulin resistance, elevated glomerular filtration fraction, and renal injury. Hypertension 1996; 28: 127-132.Diamond J. Focal and segmental glomerulosclerosis: analogies to atherosclerosis. Kidney Int 1988;.33: 917-924.Diamond J. Focal and segmental glomerulosclerosis: analogies to atherosclerosis. Kidney Int 1988;.33: 917-924.Egido J. Vasoactive hormones and renal sclerosis. Kidney Int 1996;.49: 578-597.Egido J. Vasoactive hormones and renal sclerosis. Kidney Int 1996;.49: 578-597.Ellis D., Lloyd C., Becker D.J. et al. The changing course of diabetic nephropathy: Low-density lipoprotein cholesterol and blood pressure correlate with regression of proteinuria. Am J Kidney Dis 1996; 27:.809-818.Ellis D., Lloyd C., Becker D.J. et al. The changing course of diabetic nephropathy: Low-density lipoprotein cholesterol and blood pressure correlate with regression of proteinuria. Am J Kidney Dis 1996; 27:.809-818.Enalapril in Hypertension Study Group (UK). Enalapril in essential hypertension: a comparative study with propranolol. Br J Clin Pharmacol 1984; 18: 51-56.Enalapril in Hypertension Study Group (UK). Enalapril in essential hypertension: a comparative study with propranolol. Br J Clin Pharmacol 1984; 18: 51-56.Engeli S., Negel R., Sharma A.M. Physiology and pathophysiology of the adipose tissue renin-angiotensin system. Hypertension 2000; 35: 1270.Engeli S., Negel R., Sharma A.M. Physiology and pathophysiology of the adipose tissue renin-angiotensin system. Hypertension 2000; 35: 1270.Fernández-Real J.M., Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocrine Reviews 2003; 24; 3: 278-301.Fernández-Real J.M., Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocrine Reviews 2003; 24; 3: 278-301.Feskens E.J., Loeber J.G., Kromhout D. Diet and physical activity as determinants of hyperinsulinaemia: the Zutphen Elderly Study. Am J Epidemiol 1994; 140: 350-360.Feskens E.J., Loeber J.G., Kromhout D. Diet and physical activity as determinants of hyperinsulinaemia: the Zutphen Elderly Study. Am J Epidemiol 1994; 140: 350-360.Fries J.U., Sanstrom D., Meyer T.W., Rennke J.D. Glomerular hypertrophy and epithelial cell injury are demonstrated of progressive glomerulosclerosis in the rat. Kidney Int (Abstract) 1988; 33: 374.Fries J.U., Sanstrom D., Meyer T.W., Rennke J.D. Glomerular hypertrophy and epithelial cell injury are demonstrated of progressive glomerulosclerosis in the rat. Kidney Int (Abstract) 1988; 33: 374.Fruhbeck G., Jebb S.A., Prentice A.M. Leptin: physiology and pathophysiology. Clin Physiol 1998; 18: 399-419.Fruhbeck G., Jebb S.A., Prentice A.M. Leptin: physiology and pathophysiology. Clin Physiol 1998; 18: 399-419.Goossens G.H., Blaak E.E., van Baak M.A. Possible involvement of the adipose tissue renin-angiotensin system in the pathophysiology of obesity and obesity-related disorders. Obesity Rev 2003; 4: 43-55.Goossens G.H., Blaak E.E., van Baak M.A. Possible involvement of the adipose tissue renin-angiotensin system in the pathophysiology of obesity and obesity-related disorders. Obesity Rev 2003; 4: 43-55.Grandberry M.C., Fonseca V.A. Insulin resistance syndrome: options for treatment. South Med J 1999;.92; 1: 2-15.Grandberry M.C., Fonseca V.A. Insulin resistance syndrome: options for treatment. South Med J 1999;.92; 1: 2-15.Gröne E.F., Walli A.K., Gröne H.J., Miller B., Seidel D. The role of lipids in nephrosclerosis and glomerulosclerosis. Atherosclerosis 1994; 107: 1-13.Gröne E.F., Walli A.K., Gröne H.J., Miller B., Seidel D. The role of lipids in nephrosclerosis and glomerulosclerosis. Atherosclerosis 1994; 107: 1-13.Gross J.L., de Azevedo M. J., Silveiro S.P. et al. Diabetic Nephropathy: Diagnosis, Prevention, and Treatment. Diabetes Care 2005; 28: 164-176.Gross J.L., de Azevedo M. J., Silveiro S.P. et al. Diabetic Nephropathy: Diagnosis, Prevention, and Treatment. Diabetes Care 2005; 28: 164-176.Gross M.-L., Ritz E., Schoof A. et al. Renal damage in the SHR/N-cp type 2 diabetes model: comparison of an angiotensin-converting enzyme inhibitor and endothelin receptor blocker. Laboratory Investigation 2003; 83; 9: 1267-1277.Gross M.-L., Ritz E., Schoof A. et al. Renal damage in the SHR/N-cp type 2 diabetes model: comparison of an angiotensin-converting enzyme inhibitor and endothelin receptor blocker. Laboratory Investigation 2003; 83; 9: 1267-1277.Gunter W., Sheldon C., Han D.C. et al. Leptin and renal disease. Am J Kidney Dis 2002; 39: 1-11.Gunter W., Sheldon C., Han D.C. et al. Leptin and renal disease. Am J Kidney Dis 2002; 39: 1-11.Hall J.E., Guyton A.C. Control of sodium excretion and arterial pressure by intrarenal mechanisms and the renin-angiotensin system. In: Laragh J.H., Brenner B.M., eds. Hypertension: Pathophysiology, Diagnosis and Management. New York, NY: Raven Press Publishers 1990: 1105-1130.Hall J.E., Guyton A.C. Control of sodium excretion and arterial pressure by intrarenal mechanisms and the renin-angiotensin system. In: Laragh J.H., Brenner B.M., eds. Hypertension: Pathophysiology, Diagnosis and Management. New York, NY: Raven Press Publishers 1990: 1105-1130.Han T.S., van Leer E.M., Seidell J.C. et al. Waist circumference action levels in identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401-1405.Han T.S., van Leer E.M., Seidell J.C. et al. Waist circumference action levels in identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401-1405.Hansson L., Lindholm L.H., Niskanen L. et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomized trial. Lancet 1999; 353: 611-616.Hansson L., Lindholm L.H., Niskanen L. et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomized trial. Lancet 1999; 353: 611-616.Henegar J.R., Bigler S.A., Henegar L.K., Tyagi S.C., Hall J.E. Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol 2001; 12: 1211-1217.Henegar J.R., Bigler S.A., Henegar L.K., Tyagi S.C., Hall J.E. Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol 2001; 12: 1211-1217.Henriksen E.J., Jacob S., Kinnick T.R., Teachey M.K., Krekler M. Selective angiotensin II receptor antagonism reduces insulin resistance in obese Zucker rats. Hypertension 2001; 38: 884.Henriksen E.J., Jacob S., Kinnick T.R., Teachey M.K., Krekler M. Selective angiotensin II receptor antagonism reduces insulin resistance in obese Zucker rats. Hypertension 2001; 38: 884.Hostetter T.H., Rennke H.G., Brenner B.M. The case for intrarenal hypertension in the initiation and progression of diabetic and other glomerulopathies. Am J Med 1982; 72: 375-380.Hostetter T.H., Rennke H.G., Brenner B.M. The case for intrarenal hypertension in the initiation and progression of diabetic and other glomerulopathies. Am J Med 1982; 72: 375-380.Humphrey L.L., Ballard D.J., Frohnert P.P. et al. Chronic renal failure in non-insulin-dependent diabetes mellitus. Ann Intern Med 1989; 111: 788-796.Humphrey L.L., Ballard D.J., Frohnert P.P. et al. Chronic renal failure in non-insulin-dependent diabetes mellitus. Ann Intern Med 1989; 111: 788-796.Johnson R.J., Kang D.H., Feig D. et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003; 41; 6: 1183-1190.Johnson R.J., Kang D.H., Feig D. et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003; 41; 6: 1183-1190.Jones B.H., Standridge M.K., Moustaid N. Angiotensin II increases lipogenesis in 3T3-L1 and human adipose cells. Endocrinology 1997; 138: 1512-1519.Jones B.H., Standridge M.K., Moustaid N. Angiotensin II increases lipogenesis in 3T3-L1 and human adipose cells. Endocrinology 1997; 138: 1512-1519.Kambham N., Markowitz G.S., Valeri A.M., Lin J., D¢Agati V.D. Obesity-related glomerulopathy: An emerging epidemic. Kidney Int 2001; 59; 4: 1498-1509.Kambham N., Markowitz G.S., Valeri A.M., Lin J., D¢Agati V.D. Obesity-related glomerulopathy: An emerging epidemic. Kidney Int 2001; 59; 4: 1498-1509.Kaplan N.M. The deadly quartet: upper-body obesity, glucose intolerance, hypertriglyceridemia and hypertension. Archives of Internal Medicine 1989; 149; 1514-1520.Kaplan N.M. The deadly quartet: upper-body obesity, glucose intolerance, hypertriglyceridemia and hypertension. Archives of Internal Medicine 1989; 149; 1514-1520.Kasiske B.L., Crosson J.T. Renal disease in patients with massive obesity. Arch Intern Med 1986; 146: 1105-1109.Kasiske B.L., Crosson J.T. Renal disease in patients with massive obesity. Arch Intern Med 1986; 146: 1105-1109.Koch R., Sharma A.M. Obesity and cardiovascular hemodynamic function. Curr Hypertens Rep 1999; 1: 127-130.Koch R., Sharma A.M. Obesity and cardiovascular hemodynamic function. Curr Hypertens Rep 1999; 1: 127-130.Kohan D.E. Endothelins in the normal and diseased kidney. Am J Kidney Dis 1996; 1: 2-26.Kohan D.E. Endothelins in the normal and diseased kidney. Am J Kidney Dis 1996; 1: 2-26.Kohno M., Horio T., Ideka M. et al. Angiotensin II stimulates endothelin-1 secretion in cultured rat mesangial cells. Kidney Int 1992; 42: 860-866.Kohno M., Horio T., Ideka M. et al. Angiotensin II stimulates endothelin-1 secretion in cultured rat mesangial cells. Kidney Int 1992; 42: 860-866.Kramer H., Molitch M.E. Screening for kidney disease in adults with diabetes. Diabetes Care 2005; 28; 7: 1813-1816.Kramer H., Molitch M.E. Screening for kidney disease in adults with diabetes. Diabetes Care 2005; 28; 7: 1813-1816.Kriz W. Progression of glomerular disease: is podocyte the culprit? Kidney Int 1998; 54 [Suppl.3]: 687-697.Kriz W. Progression of glomerular disease: is podocyte the culprit? Kidney Int 1998; 54 [Suppl.3]: 687-697.Kuiper J.J. Effects of weight reduction and angiotensin-converting enzyme inhibition on IgA nephropathy-associated proteinuria. Nephron 1996; 74; 2: 462-463.Kuiper J.J. Effects of weight reduction and angiotensin-converting enzyme inhibition on IgA nephropathy-associated proteinuria. Nephron 1996; 74; 2: 462-463.Labib М. The investigation and management of obesity. Journal of Clinical Pathology 2003; 56: 17-25.Labib М. The investigation and management of obesity. Journal of Clinical Pathology 2003; 56: 17-25.Levy D., Garrison R.J., Savage D.D. et al. Left ventricular mass and incidence of coronary heart disease in an elderly cohort. Ann Intern Med 1989; 110: 101-107.Levy D., Garrison R.J., Savage D.D. et al. Left ventricular mass and incidence of coronary heart disease in an elderly cohort. Ann Intern Med 1989; 110: 101-107.Libby P., Ridker P.M., Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105: 1135-1143.Libby P., Ridker P.M., Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105: 1135-1143.Liese A.D., Hense H.W., Brown A.A. et al. Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95. J Hum Hypertens 2001; 15: 799-804.Liese A.D., Hense H.W., Brown A.A. et al. Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95. J Hum Hypertens 2001; 15: 799-804.Livingstone B. Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159 [Suppl. 1]: 14-34.Livingstone B. Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159 [Suppl. 1]: 14-34.Mali D.D., Ma J.Z., Louis T.A. Long-term effects of antihypertensive agents on proteinuria and renal function. Arch Intern Med 1995; 155: 1073-1080.Mali D.D., Ma J.Z., Louis T.A. Long-term effects of antihypertensive agents on proteinuria and renal function. Arch Intern Med 1995; 155: 1073-1080.Matsuzawa Y., Funahashi T., Nacamura T. Molecular mechanism of metabolic syndrom X: contribution of adipocyte-derived bioactive substances. Ann N Y Acad Scin 1999; 892: 146-154.Matsuzawa Y., Funahashi T., Nacamura T. Molecular mechanism of metabolic syndrom X: contribution of adipocyte-derived bioactive substances. Ann N Y Acad Scin 1999; 892: 146-154.Mayer-Davis E.J., Monaco J.H., Hoen H.M. et al. Dietary fat and insulin sensitivity in triethnic population: the role of obesity. The Insulin Resistance Atherosclerosis Study (IRAS). Am J Clin Nutr 1997; 65: 79-87.Mayer-Davis E.J., Monaco J.H., Hoen H.M. et al. Dietary fat and insulin sensitivity in triethnic population: the role of obesity. The Insulin Resistance Atherosclerosis Study (IRAS). Am J Clin Nutr 1997; 65: 79-87.Meier-Kriesche H.U., Arndorfer J.A., Kaplan B. The impact of body mass index on renal transplant outcomes: A significant independent risk factor for graft failure and patient death. Transplantation 2002; 73; 1: 70-74.Meier-Kriesche H.U., Arndorfer J.A., Kaplan B. The impact of body mass index on renal transplant outcomes: A significant independent risk factor for graft failure and patient death. Transplantation 2002; 73; 1: 70-74.Melin J., Akyurek L.M., Kallskog O., Larsson E. Ischemia causes rapidly progressive nephropathy in the diabetic rat. Kidney Int 1997; 52: 985-991.Melin J., Akyurek L.M., Kallskog O., Larsson E. Ischemia causes rapidly progressive nephropathy in the diabetic rat. Kidney Int 1997; 52: 985-991.Mogensen C.E., Viberti G., Halimi S. et al. Effect of low-dose perindopril/indapamide on albuminuria in diabetes. Hypertension 2003; 41: 1063.Mogensen C.E., Viberti G., Halimi S. et al. Effect of low-dose perindopril/indapamide on albuminuria in diabetes. Hypertension 2003; 41: 1063.Mokdad A.H. et al. Diabetes trends in the United States, 1990-1998. Diabetes Care 2000; 23: 1278-1283.Mokdad A.H. et al. Diabetes trends in the United States, 1990-1998. Diabetes Care 2000; 23: 1278-1283.Müller M.J., Danielzik S. Prävention ernährungsabhängiger Erkrankungen. Adipositas, Diabetes mellitus. Internist 2004; 45; 2: 168-172.Müller M.J., Danielzik S. Prävention ernährungsabhängiger Erkrankungen. Adipositas, Diabetes mellitus. Internist 2004; 45; 2: 168-172.Myers B.D., Nelson R.G., Tan M. et al. Progression of overt nephropathy in non-insulin-dependent diabetes. Kidney Int 1995; 47: 1781-1789.Myers B.D., Nelson R.G., Tan M. et al. Progression of overt nephropathy in non-insulin-dependent diabetes. Kidney Int 1995; 47: 1781-1789.Nabokov A., Amann K., Wagner J. et al. Influence of specific and non-specific endothelin receptor antagonists on renal morphology in rats with renal ablation. Nephrol Dial Transplant 1996; 11: 514-520.Nabokov A., Amann K., Wagner J. et al. Influence of specific and non-specific endothelin receptor antagonists on renal morphology in rats with renal ablation. Nephrol Dial Transplant 1996; 11: 514-520.Nadler S. T., Stoehr J.P., Schueler K.L. et al. The expression of adipogenic genes is decreased in obesity and diabetes mellitus. Proc Natl Acad Sci USA 2000; 97; 21: 11371-11376.Nadler S. T., Stoehr J.P., Schueler K.L. et al. The expression of adipogenic genes is decreased in obesity and diabetes mellitus. Proc Natl Acad Sci USA 2000; 97; 21: 11371-11376.Praga M., Hernández E., Herrero J.C. et al. Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int 2000; 58: 2111-2118.Praga M., Hernández E., Herrero J.C. et al. Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int 2000; 58: 2111-2118.Praga M., Hernández E., Morales E. et al. Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant 2001; 16: 1790-1798.Praga M., Hernández E., Morales E. et al. Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant 2001; 16: 1790-1798.Purnell J., Brunzell J. The central role of dietary fat, not carbohydrate, in the insulin resistance syndrome Curr Opin Lipidol 1997; 8; 1: 17-22.Purnell J., Brunzell J. The central role of dietary fat, not carbohydrate, in the insulin resistance syndrome Curr Opin Lipidol 1997; 8; 1: 17-22.Reaven G.M. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-1607.Reaven G.M. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-1607.Remuzzi G., Bertani T. Pathophysiology of progressive nephropathies. N Engl J Med 1998; 339; 12: 1448-1456.Remuzzi G., Bertani T. Pathophysiology of progressive nephropathies. N Engl J Med 1998; 339; 12: 1448-1456.Ruiz-Ortega M., Gomez-Garre D., Alcazar R. et al. Involvement of angiotensin II and endothelin in matrix protein production and renal sclerosis. J Hypertens 1994; 12: 551-558.Ruiz-Ortega M., Gomez-Garre D., Alcazar R. et al. Involvement of angiotensin II and endothelin in matrix protein production and renal sclerosis. J Hypertens 1994; 12: 551-558.Sattar N., Gaw A., Scherbakova O. et al. Metabolic syndrome with and without C-peptid protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108: 414-419.Sattar N., Gaw A., Scherbakova O. et al. Metabolic syndrome with and without C-peptid protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108: 414-419.Saxena A.K., Chopra R. Renal risk of an emerging «Epidemic» of obesity: the role of adipocyte-derived Factors. Dialysis and Transplantation 2004; 33: 11-20.Saxena A.K., Chopra R. Renal risk of an emerging «Epidemic» of obesity: the role of adipocyte-derived Factors. Dialysis and Transplantation 2004; 33: 11-20.Schmitz A. The kidney in non-insulin-dependent diabetes. Acta Diabetol 1992; 29: 47-69.Schmitz A. The kidney in non-insulin-dependent diabetes. Acta Diabetol 1992; 29: 47-69.Segarra A., Chacon P., Martines-Eyarre C. et al. Circulating levels of plasminogen activator inhibitor type-1 tissue plasminogen activator, and thrombomodulin in hemodialysis patients: biochemical correlations and role as independent predictors of coronary artery stenosis. J Am Soc Nephrol 2001; 12: 1255-1263.Segarra A., Chacon P., Martines-Eyarre C. et al. Circulating levels of plasminogen activator inhibitor type-1 tissue plasminogen activator, and thrombomodulin in hemodialysis patients: biochemical correlations and role as independent predictors of coronary artery stenosis. J Am Soc Nephrol 2001; 12: 1255-1263.Seidell J. Obesity in Europe. Obes Res 1995; 3 [Suppl. 2]: 89s-93s.Seidell J. Obesity in Europe. Obes Res 1995; 3 [Suppl. 2]: 89s-93s.Sonnenberg G.E., Krakower G.R., Kissebah A.H. A novel pathway to the manifestations of metabolic syndrome. Obesity Research 2004; 12; 2: 180-192.Sonnenberg G.E., Krakower G.R., Kissebah A.H. A novel pathway to the manifestations of metabolic syndrome. Obesity Research 2004; 12; 2: 180-192.Stern J., Hirsch J., Blair S., Foreyt J., Frank A. et al. Weighing the options: criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity. Obes Res 1995; 6: 591-604.Stern J., Hirsch J., Blair S., Foreyt J., Frank A. et al. Weighing the options: criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity. Obes Res 1995; 6: 591-604.Stjrlien L.H., Jenkins A.B., Chisholm D.J. et al. Influence of dietary fat composition on development of insulin resistance in rats. Relationship to muscle triglyceride and w-3 fatty acids in muscle phospholipid. Diabetes 1991; 40: 280-289.Stjrlien L.H., Jenkins A.B., Chisholm D.J. et al. Influence of dietary fat composition on development of insulin resistance in rats. Relationship to muscle triglyceride and w-3 fatty acids in muscle phospholipid. Diabetes 1991; 40: 280-289.Sugerman H.J. Effects of increased intraabdominal pressure in severe obesity. Surg Clin North Am 2001; 81; 5: 1063-1075.Sugerman H.J. Effects of increased intraabdominal pressure in severe obesity. Surg Clin North Am 2001; 81; 5: 1063-1075.Sun Z., Andersson R. NF-kB activation and inhibition: a review. Shock 2002; 18: 99-106.Sun Z., Andersson R. NF-kB activation and inhibition: a review. Shock 2002; 18: 99-106.The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-153.The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-153.Unger R.H. Lipotoxic Diseases. Annu Rev Mad 2002; 53: 319-336.Unger R.H. Lipotoxic Diseases. Annu Rev Mad 2002; 53: 319-336.Verani R.R. Obesity-associated FSGS: Pathologic features of lesion and relationship with cardiomegaly and hyperlipidemia. Am J Kidney Dis 1992; 20: 629-634.Verani R.R. Obesity-associated FSGS: Pathologic features of lesion and relationship with cardiomegaly and hyperlipidemia. Am J Kidney Dis 1992; 20: 629-634.Wesson D.E., Kurtzman N.A., Frommer J.P. Massive obesity and nephrotic proteinuria with a normal renal biopsy. Nephron 1985; 40: 235-237.Wesson D.E., Kurtzman N.A., Frommer J.P. Massive obesity and nephrotic proteinuria with a normal renal biopsy. Nephron 1985; 40: 235-237.Weyer C., Snutker S., Rising R. et al. Determinants of energy expenditure and fuel utilization in man: effects of body composition, age, sex, ethnicity and glucose tolerance in 916 subjects. Int J Obes Relat Metab Disord 1999; 23; 7: 715-737.Weyer C., Snutker S., Rising R. et al. Determinants of energy expenditure and fuel utilization in man: effects of body composition, age, sex, ethnicity and glucose tolerance in 916 subjects. Int J Obes Relat Metab Disord 1999; 23; 7: 715-737.Więcek A., Kokot F., Chudek J., Adamczak M. The adipose tissue - a novel endocrine organ of interest to the nephrologist. Nephrol Dial Transplant 2002; 17: 191-195.Więcek A., Kokot F., Chudek J., Adamczak M. The adipose tissue - a novel endocrine organ of interest to the nephrologist. Nephrol Dial Transplant 2002; 17: 191-195.Wolf G., Hamman A., Han D.C. et al. Leptin stimulates proliferation and TGF-b expression in renal glomerular endothelial cells: Potential role in glomerulosclerosis. Kidney Int 1999; 56: 860-872.Wolf G., Hamman A., Han D.C. et al. Leptin stimulates proliferation and TGF-b expression in renal glomerular endothelial cells: Potential role in glomerulosclerosis. Kidney Int 1999; 56: 860-872.Writa O.R., Pasternack A.I., Mustonen J.T. et al. Urinary albumin excretion rate and its determinants after 6 years in non-insulin-dependent diabetic patients. Nephrol Dial Transplant 1996; 11: 449-456.Writa O.R., Pasternack A.I., Mustonen J.T. et al. Urinary albumin excretion rate and its determinants after 6 years in non-insulin-dependent diabetic patients. Nephrol Dial Transplant 1996; 11: 449-456.Ziegler O., Quilliot D., Guerci B., Drouin P. Macronutrients, fat mass, fatty acid flux and insulin sensitivity. Diabetes Metab 2001; 27; 2Pt2: 261-270.Ziegler O., Quilliot D., Guerci B., Drouin P. Macronutrients, fat mass, fatty acid flux and insulin sensitivity. Diabetes Metab 2001; 27; 2Pt2: 261-270.Ziyadeh F.N. Significance of tubulointerstitial changes in diabetic renal disease. Kidney Int 1996; 49: 10-13.Ziyadeh F.N. Significance of tubulointerstitial changes in diabetic renal disease. Kidney Int 1996; 49: 10-13.

The authors declare that there are no conflicts of interest present.