Narrative review describes inflammatory and lipotoxicity mechanisms in obesity-related chronic kidney disease

This narrative review examines the inflammatory and lipotoxicity mechanisms underlying obesity-related chronic kidney disease (Ob-CKD) in patients with CKD affected by obesity. The review describes potential direct mechanisms affecting the kidneys in obesity, including hyperfiltration, renin-angiotensin-aldosterone system (RAAS) activation, inflammation, lipotoxicity, and neurohormonal activation. Structural changes associated with these mechanisms include glomerular hypertrophy, podocytopathy, mesangial matrix expansion, focal segmental glomerulosclerosis, tubulointerstitial fibrosis, vascular lesions, and tubular atrophy.

No quantitative results, clinical outcomes, or intervention data are reported in this review. The authors describe associations between mechanisms and disease processes but do not establish causation. The review does not include comparative data between different patient groups or treatment approaches.

Safety and tolerability information is not reported, as this is a mechanistic review rather than an interventional study. Key limitations include the narrative review format, which does not constitute primary research evidence. The review synthesizes existing mechanistic understanding but does not provide new clinical trial data or quantitative outcomes.

Practice relevance is not reported, and clinicians should recognize this as a descriptive overview of potential pathophysiological pathways. The review may inform understanding of Ob-CKD mechanisms but does not provide evidence to guide specific clinical interventions or management strategies.