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Category: Volume 08 Issue 11 November 2020
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Title: Obesity: A Growing Risk Factor for Cardiorenal Syndrome

Authors: Divya Joyce S, Umarani R, Vijayakumar N

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.70

Abstract

Obesity and its associated comorbidities like diabetes, hypertension are among the significant risk factors for heart failure and kidney disease. Visceral obesity is robustly associated with a greater risk of cardiorenal morbidity than subcutaneous obesity. Cardiac impairment in obesity is caused by hemodynamic changes, endothelial dysfunction, RAAS activation, neurohormonal dysregulation, oxidative stress and adipokines causing inflammation. Obesity impairs kidney function by hyper-filtration, increased glomerular capillary wall tension, podocyte dysfunction and finally causing CKD. This review article discuss the relationship and significance of smoking, hypertension, alcohol intake, diabetes mellitus, obesity and anemia in cardio renal syndrome in acute heart failure patients.

References

  1. Messerli, F. H., Rimoldi, S. F., & Bangalore, S. (2017). The transition from hypertension to heart failure: contemporary update. JACC: Heart Failure, 5(8), 543-551.
  2. Levy D, Garrison RJ, Savage DD., et al: Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990;322:1561–6.
  3. Sicree R. Diabetes Atlas, 3rd ed., Brussels: International Diabetes Federation; 2008.
  4. Fuad N, Ziyadeh. Different roles for TGF-b and VEGF in the pathogenesis of the cardinal features of diabetic nephropathy. Diabetes Res Clin Pract 2008;82(Suppl. 1): S38–41.
  5. Forman DE, Butler J, Wang Y, Abraham WT, O’Connor CM, Gottlieb SS, et al. Incidence, predictors at admission, and impact of worsening renal function among patients hospitalized with heart failure. J Am Coll Cardiol 2004;43:61–7.
  6. Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS., et al:. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377: 13-27
  7. Aglae C, Muller L., et al: Heterogeneity of Cause, Care, and Prognosis in Severe Acute Kidney Injury in Hospitalized Patients: A Prospective Observational Study. Can J Kidney Health Dis 2019;6:2054358 119892174
  8. Eschalier R, Rossignol P., et al: Features of cardiac remodeling, associated with blood pressure and fibrosis biomarkers, are frequent in subjects with abdominal obesity. Hypertension 2014; 63: 740-746
  9. Lee TC, Jin Z, Homma S., et al:. Changes in Left Ventricular Mass and Geometry in the Older Adults: Role of Body Mass and Central Obesity. J Am Soc Echocardiogr 2019; 32: 1318-1325
  10. S. Department of Health and Human Services: The Surgeon General’s Vision for a Healthy and Fit Nation. Rock-ville, U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.
  11. Mottillo S, Filion KB., et al: The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010; 56: 1113-1132
  12. McClellan WM, Flanders WD., et al: The interaction between Heart failure, Renal Failure and Anemia – The Caridorenal Syndrome: Blood Purif 2004;22:277–84. [5]
  13. Deepa M. Gopal, MD., et al: Cigarette Smoking Exposure and Heart Failure Risk in Older Adults: The Health, Aging, and Body Composition Study Am Heart J. 2012 Aug; 164(2): 236–242.doi: 1016/j.ahj.2012.05.013.
  14. Zoltan V. Varga, M.D., Ph.D., Csaba Matyas, M.D., Janos Paloczi, Ph.D., and Pal Pacher, M.D., Ph.D. Alcohol Res. 2017; 38(2): 283–288.
  15. Harada PH, Bensenõr IJM, Drager LF, Goulart AC, Mill JG, Lotufo PA. Non-alcoholic fatty liver disease presence and severity are associated with aortic stiffness beyond abdominal obesity: The ELSA-Brasil. Atherosclerosis 2019; 284: 59-65
  16. Grams ME, Juraschek SP., et al:. Trends in the prevalence of reduced GFR in the United States: a comparison of creatinine- and cystatin C-based estimates. Am Kidney Dis 2013; 62: 253-260
  17. Upadhya B, Amjad A, Stacey RB. Optimizing The Management of Obese HFpEF Phenotype: Can We Mind Both The Heart and The Kidney? J Card Fail 2020; 26: 108-111
  18. Wickman C, Kramer H. Obesity and kidney disease: potential mechanisms. Semin Nephrol 2013; 33: 14-22
  19. Wing RR, Marcus MD., et al: Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects. Arch Intern Med 1991;151:1334–1340.
  20. Klein S, Fabbrini E, Romijn JA: Williams Textbook of Endocrinology, ed 12, pp 1605–1622.

Corresponding Author

Umarani R

Professor, Department of General Medicine, Rajah Muthiah Medical College & Hospital