Obesity-related glomerulopathy, a growing kidney burden in the obesity pandemic

Authors

Mahtab Mashayekhi, Division of Nephrology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
Jonathan E. Zuckerman, Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Sahar H. Koubar, Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, MN, USA.
Junnan Wu, Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
Jianbo Qing, Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
Amir Abdipour, Division of Nephrology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
Edgar Lerma, Advocate Health - MidwestFollow
Warren Peters, Obesity Research, Loma Linda University School of Public Health, Loma Linda, USA.
Sayna Norouzi, Division of Nephrology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA. snorouzi@llu.edu.

Recommended Citation

Mashayekhi M, Zuckerman JE, Koubar SH, et al. Obesity-related glomerulopathy, A growing kidney burden in the obesity pandemic. Clin Exp Nephrol. Published online December 18, 2025. doi:10.1007/s10157-025-02804-7

Affiliations

Advocate Christ Medical Center

Abstract

Obesity can cause the progression of kidney disease through hemodynamic, structural, and metabolic changes, and predispose individuals to arterio-nephrosclerosis, diabetic nephropathy, and focal segmental glomerulosclerosis (FSGS), leading to chronic kidney disease (CKD). Obesity-Related Glomerulopathy (ORG) is defined as clinical obesity and biopsy-proven glomerulomegaly with or without the existence of FSGS. However, pathologic changes of ORG are not pathognomonic or specific. Glomerular hypertrophy, maladaptive segmental glomerulosclerosis, as well as in some cases diabetic-like changes may be seen secondary to any cause of acquired or congenital reduced nephron mass with compensatory hypertrophy as well as glomerular hypoxia. This review aims to provide a comprehensive overview of the mechanisms causing ORG and explore current diagnostic challenges and therapeutic strategies, emphasizing the role of weight management and emerging targeted therapies.

Document Type

Article

PubMed ID

41410808