Nephrotic-range proteinuria  in the obese patient

Lim, Andy K H

doi:10.5694/j.1326-5377.2006.tb00624.x

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To the Editor: The incidence of obesity is rising, and physicians are likely to face the problem of obesity-related glomerulopathy (ORG) recently illustrated by Tran.1 But how can the clinician distinguish ORG from primary (idiopathic) focal segmental glomerulosclerosis (FSGS)? Both may present with nephrotic-range proteinuria, but the prognosis and choice of treatment may differ.

Monash Medical Centre, Melbourne, VIC.

Correspondence: andy.lim@med.monash.edu.au

1. Tran HA. Reversible obesity-related glomerulopathy following weight reduction [letter]. Med J Aust 2006; 184: 367. <MJA full text>
2. Kambham N, Markowitz GS, Valeri AM, et al. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 2001; 59: 1498-1509.
3. Chagnac A, Weinstein T, Herman M, et al. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol 2003; 14: 1480-1486.
4. Chun MJ, Korbet SM, Schwartz MM, Lewis EJ. Focal segmental glomerulosclerosis in nephrotic adults: presentation, prognosis, and response to therapy of the histologic variants. J Am Soc Nephrol 2004; 15: 2169-2177.
5. Thomas DB, Franceschini N, Hogan SL, et al. Clinical and pathologic characteristics of focal segmental glomerulosclerosis pathologic variants. Kidney Int 2006; 69: 920-926.

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