Ribstein J, du Cailar G, Mimran A
Combined renal effects of overweight and hypertension

Hypertension (Oct) 26:610-615 1995

While hypertension is more common in obese individuals, the effects of obesity on the target organs of hypertension have not been well studied. Ribstein et al measured GFR and RPF using radioactive tracers in 40 normotensive and 80 never-treated hypertensive subjects, of which half were lean and half were to moderately obese (body mass index 27-40 kg/m2). All were less than 60 years of age. Glucose tolerance tests were done, and microalbuminuria was quantified.

GFR and RPF were similar in lean and obese patients when corrected for body surface area, but were greater in obese subjects if corrected for height only. GFR correlated with protein intake, as assessed by urinary urea excretion. Urinary albumin excretion was higher in hypertensives than in normotensives, and higher in obese normotensives and obese hypertensives than in their lean counterparts, despite comparable levels of blood pressure. Fasting serum insulin levels correlated with GFR but not RPF.

Comment: The authors are attempting to link obesity with hyperfiltration and subsequent renal injury. Part of this depends on how the values are corrected (height vs. BSA). However,the root cause of the hyperfiltration observed in obese subjects might well have been dietary, as the urinary urea excretions were 30-40% higher in obese patients on average, than in their lean counterparts. (Daugirdas)

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H: Special problems : Obesity, Insulin Resistance
H: Pathophysiology : Kidney in hypertension