|
|
Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment |
Tianhua Xu, Zitong Sheng, Li Yao() |
Department of Nephrology, The First Hospital of China Medical University, Shenyang 110001, China |
|
|
Abstract In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria (<3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin–angiotensin–aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.
|
Keywords
obesity-related glomerulopathy
pathogenesis
pathologic
clinical characteristics
|
Corresponding Author(s):
Li Yao
|
Just Accepted Date: 20 July 2017
Online First Date: 09 August 2017
Issue Date: 29 August 2017
|
|
1 |
Jia W. Obesity in China: its characteristics, diagnostic criteria, and implications. Front Med 2015; 9(2): 129–133
https://doi.org/10.1007/s11684-015-0387-x
pmid: 25620117
|
2 |
Kambham N, Markowitz GS, Valeri AM , Lin J, D’Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 2001; 59(4): 1498–1509
https://doi.org/10.1046/j.1523-1755.2001.0590041498.x
pmid: 11260414
|
3 |
D’Agati VD, Chagnac A, de Vries AP , Levi M, Porrini E, Herman-Edelstein M , Praga M . Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016; 12(8): 453–471
pmid: 27263398
|
4 |
D’Agati VD, Kaskel FJ, Falk RJ . Focal segmental glomerulosclerosis. N Engl J Med 2011; 365(25): 2398–2411
https://doi.org/10.1056/NEJMra1106556
pmid: 22187987
|
5 |
Serra A, Romero R, Lopez D , Navarro M , Esteve A , Perez N , Alastrue A , Ariza A . Renal injury in the extremely obese patients with normal renal function. Kidney Int 2008; 73(8): 947–955
https://doi.org/10.1038/nrneph.2016.75
pmid: 18216780
|
6 |
Hughson MD, Hoy WE, Douglas-Denton RN , Zimanyi MA , Bertram JF . Towards a definition of glomerulomegaly: clinical-pathological and methodological considerations. Nephrol Dial Transplant 2011; 26(7): 2202–2208
https://doi.org/10.1093/ndt/gfq688
pmid: 21115671
|
7 |
de Vries AP, Ruggenenti P, Ruan XZ , Praga M , Cruzado JM , Bajema IM , D’Agati VD , Lamb HJ , Pongrac Barlovic D , Hojs R, Abbate M, Rodriquez R , Mogensen CE , Porrini E; ERA-EDTA Working Group Diabesity.Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol 2014; 2(5): 417–426
https://doi.org/10.1016/S2213-8587(14)70065-8
pmid: 24795255
|
8 |
Praga M, Morales E. The fatty kidney: obesity and renal disease. Nephron 2016 Jul 15. [Epub ahead of print] doi:10.1159/000447674
https://doi.org/10.1159/000447674
pmid: 27414023
|
9 |
Chagnac A, Weinstein T, Korzets A , Ramadan E , Hirsch J , Gafter U . Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol 2000; 278(5): F817–F822
pmid: 10807594
|
10 |
Fukuda A, Chowdhury MA, Venkatareddy MP , Wang SQ , Nishizono R , Suzuki T , Wickman LT , Wiggins JE , Muchayi T , Fingar D , Shedden KA , Inoki K , Wiggins RC . Growth-dependent podocyte failure causes glomerulosclerosis. J Am Soc Nephrol 2012; 23(8): 1351–1363
https://doi.org/10.1681/ASN.2012030271
pmid: 22773827
|
11 |
Liu Y. New insights into epithelial-mesenchymal transition in kidney fibrosis. J Am Soc Nephrol 2010; 21(2): 212–222
https://doi.org/10.1681/ASN.2008121226
pmid: 20019167
|
12 |
Matsusaka T, Sandgren E, Shintani A , Kon V, Pastan I, Fogo AB , Ichikawa I . Podocyte injury damages other podocytes. J Am Soc Nephrol 2011; 22(7): 1275–1285
https://doi.org/10.1681/ASN.2010090963
pmid: 21719786
|
13 |
Bobulescu IA, Lotan Y, Zhang J , Rosenthal TR , Rogers JT , Adams-Huet B , Sakhaee K , Moe OW. Triglycerides in the human kidney cortex: relationship with body size. PLoS One 2014; 9(8): e101285. doi: 10.1371 /journal.pone.0101285
https://doi.org/10.1371 /journal.pone.0101285
|
14 |
Stefan N, Artunc F, Heyne N , Machann J , Schleicher ED , Häring HU . Obesity and renal disease: not all fat is created equal and not all obesity is harmful to the kidneys. Nephrol Dial Transplant 2016; 31(5): 726–730
https://doi.org/10.1093/ndt/gfu081
pmid: 24753460
|
15 |
Wu Y, Liu Z, Xiang Z , Zeng C, Chen Z, Ma X , Li L. Obesity-related glomerulopathy: insights from gene expression profiles of the glomeruli derived from renal biopsy samples. Endocrinology 2006; 147(1): 44–50
https://doi.org/10.1210/en.2005-0641
pmid: 16210374
|
16 |
Bonnet F, Deprele C, Sassolas A , Moulin P , Alamartine E , Berthezène F , Berthoux F . Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA nephritis. Am J Kidney Dis 2001; 37(4): 720–727
https://doi.org/10.1016/S0272-6386(01)80120-7
pmid: 11273871
|
17 |
D’Agati VD, Markowitz GS. Supersized kidneys: lessons from the preclinical obese kidney. Kidney Int 2008; 73(8): 909–910
https://doi.org/10.1038/ki.2008.42
pmid: 18379527
|
18 |
Felizardo RJ, da Silva MB, Aguiar CF , Câmara NO . Obesity in kidney disease: a heavyweight opponent. World J Nephrol 2014; 3(3): 50–63
https://doi.org/10.5527/wjn.v3.i3.50
pmid: 25332896
|
19 |
Weisinger JR, Kempson RL, Eldridge FL , Swenson RS . The nephrotic syndrome: a complication of massive obesity. Ann Intern Med 1974; 81(4): 440–447
https://doi.org/10.7326/0003-4819-81-4-440
pmid: 4416380
|
20 |
Kriz W, Lemley KV. A potential role for mechanical forces in the detachment of podocytes and the progression of CKD. J Am Soc Nephrol 2015; 26(2): 258–269
https://doi.org/10.1681/ASN.2014030278
pmid: 25060060
|
21 |
Wuerzner G, Pruijm M, Maillard M , Bovet P , Renaud C , Burnier M , Bochud M . Marked association between obesity and glomerular hyperfiltration: a cross-sectional study in an African population. Am J Kidney Dis 2010; 56(2): 303–312
https://doi.org/10.1053/j.ajkd.2010.03.017
pmid: 20538392
|
22 |
Chagnac A, Weinstein T, Herman M , Hirsh J , Gafter U , Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol 2003; 14(6): 1480–1486
https://doi.org/10.1097/01.ASN.0000068462.38661.89
pmid: 12761248
|
23 |
Novikov A, Vallon V. Sodium glucose cotransporter 2 inhibition in the diabetic kidney: an update. Curr Opin Nephrol Hypertens 2016; 25(1): 50–58
https://doi.org/10.1097/MNH.0000000000000187
pmid: 26575393
|
24 |
Zinman B, Wanner C, Lachin JM , Fitchett D , Bluhmki E , Hantel S , Mattheus M , Devins T , Johansen OE , Woerle HJ , Broedl UC , Inzucchi SE; EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373(22): 2117–2128
https://doi.org/10.1056/NEJMoa1504720
pmid: 26378978
|
25 |
Zingerman B, Herman-Edelstein M, Erman A , Bar Sheshet Itach S , Ori Y, Rozen-Zvi B, Gafter U , Chagnac A . Effect of acetazolamide on obesity-induced glomerular hyperfiltration: a randomized controlled trial. PLoS One 2015; 10(9): e0137163
https://doi.org/10.1371/journal.pone.0137163
pmid: 26367377
|
26 |
Nishiyama A, Abe Y. Molecular mechanisms and therapeutic strategies of chronic renal injury: renoprotective effects of aldosterone blockade. J Pharmacol Sci 2006; 100(1): 9–16
https://doi.org/10.1254/jphs.FMJ05003X3
pmid: 16397374
|
27 |
Ribstein J, Du Cailar G, Fesler P , Mimran A . Relative glomerular hyperfiltration in primary aldosteronism. J Am Soc Nephrol 2005; 16(5): 1320–1325
https://doi.org/10.1681/ASN.2004100878
pmid: 15800124
|
28 |
Kawarazaki W, Nagase M, Yoshida S , Takeuchi M , Ishizawa K , Ayuzawa N , Ueda K, Fujita T. Angiotensin II- and salt-induced kidney injury through Rac1-mediated mineralocorticoid receptor activation. J Am Soc Nephrol 2012; 23(6): 997–1007
https://doi.org/10.1681/ASN.2011070734
pmid: 22440899
|
29 |
De Cosmo S, Menzaghi C, Prudente S , Trischitta V . Role of insulin resistance in kidney dysfunction: insights into the mechanism and epidemiological evidence. Nephrol Dial Transplant 2013; 28(1): 29–36
https://doi.org/10.1093/ndt/gfs290
pmid: 23048172
|
30 |
Chen S, Chen Y, Liu X , Li M, Wu B, Li Y , Liang Y , Shao X, Holthöfer H, Zou H . Association of insulin resistance with chronic kidney disease in non-diabetic subjects with normal weight. PLoS One 2013; 8(9): e74058.doi: 10.1371/journal.pone.0074058
https://doi.org/10.1371/journal.pone.0074058
|
31 |
Redon J, Lurbe E. The kidney in obesity. Curr Hypertens Rep 2015; 17(6): 555
https://doi.org/10.1007/s11906-015-0555-z
pmid: 25893477
|
32 |
Ye J. Mechanisms of insulin resistance in obesity. Front Med 2013; 7(1): 14–24
https://doi.org/10.1007/s11684-013-0262-6
pmid: 23471659
|
33 |
Szeto HH, Liu S, Soong Y , Alam N, Prusky GT, Seshan SV . Protection of mitochondria prevents high-fat diet-induced glomerulopathy and proximal tubular injury. Kidney Int 2016; 90(5): 997–1011
https://doi.org/10.1016/j.kint.2016.06.013
pmid: 27519664
|
34 |
Tang C, Cai J, Dong Z . Mitochondrial dysfunction in obesity-related kidney disease: a novel therapeutic target. Kidney Int 2016; 90(5): 930–933
https://doi.org/10.1016/j.kint.2016.07.045
pmid: 27742195
|
35 |
Herman-Edelstein M , Scherzer P , Tobar A , Levi M, Gafter U. Altered renal lipid metabolism and renal lipid accumulation in human diabetic nephropathy. J Lipid Res 2014; 55(3): 561–572
https://doi.org/10.1194/jlr.P040501
pmid: 24371263
|
36 |
Sharma K. Obesity, oxidative stress, and fibrosis in chronic kidney disease. Kidney Int Suppl (2011) 2014; 4(1): 113–117
https://doi.org/10.1038/kisup.2014.21
pmid: 25401040
|
37 |
Declèves AE , Zolkipli Z , Satriano J , Wang L, Nakayama T, Rogac M , Le TP, Nortier JL, Farquhar MG , Naviaux RK , Sharma K . Regulation of lipid accumulation by AMP-activated kinase [corrected] in high fat diet-induced kidney injury. Kidney Int 2014; 85(3): 611–623
https://doi.org/10.1038/ki.2013.462
pmid: 24304883
|
38 |
Dugan LL, You YH, Ali SS , Diamond-Stanic M , Miyamoto S , DeCleves AE , Andreyev A , Quach T , Ly S, Shekhtman G, Nguyen W , Chepetan A , Le TP, Wang L, Xu M , Paik KP , Fogo A, Viollet B, Murphy A , Brosius F , Naviaux RK , Sharma K . AMPK dysregulation promotes diabetes-related reduction of superoxide and mitochondrial function. J Clin Invest 2013; 123(11): 4888–4899
https://doi.org/10.1172/JCI66218
pmid: 24135141
|
39 |
Manabe I. Chronic inflammation links cardiovascular, metabolic and renal diseases. Circ J 2011; 75(12): 2739–2748
https://doi.org/10.1253/circj.CJ-11-1184
pmid: 22067929
|
40 |
Nolan E, O’Meara YM, Godson C . Lipid mediators of inflammation in obesity-related glomerulopathy. Nephrol Dial Transplant 2013; 28(4 Suppl 4): iv22–iv29
pmid: 24081855
|
41 |
Young CN, Morgan DA, Butler SD , Mark AL , Davisson RL . The brain subfornical organ mediates leptin-induced increases in renal sympathetic activity but not its metabolic effects. Hypertension 2013; 61(3): 737–744
https://doi.org/10.1161/HYPERTENSIONAHA.111.00405
pmid: 23357182
|
42 |
Nasrallah MP, Ziyadeh FN. Overview of the physiology and pathophysiology of leptin with special emphasis on its role in the kidney. Semin Nephrol 2013; 33(1): 54–65
https://doi.org/10.1016/j.semnephrol.2012.12.005
pmid: 23374894
|
43 |
Rutkowski JM, Wang ZV, Park AS , Zhang J , Zhang D , Hu MC, Moe OW, Susztak K , Scherer PE . Adiponectin promotes functional recovery after podocyte ablation. J Am Soc Nephrol 2013; 24(2): 268–282
https://doi.org/10.1681/ASN.2012040414
pmid: 23334396
|
44 |
Simonds SE, Pryor JT, Ravussin E , Greenway FL , Dileone R , Allen AM , Bassi J , Elmquist JK , Keogh JM , Henning E , Myers MG Jr, Licinio J , Brown RD , Enriori PJ , O’Rahilly S , Sternson SM , Grove KL , Spanswick DC , Farooqi IS , Cowley MA . Leptin mediates the increase in blood pressure associated with obesity. Cell 2014; 159(6): 1404–1416
https://doi.org/10.1016/j.cell.2014.10.058
pmid: 25480301
|
45 |
Ogna A, Forni Ogna V, Bochud M , Guessous I , Paccaud F , Burnier M , Wuerzner G . Association between obesity and glomerular hyperfiltration: the confounding effect of smoking and sodium and protein intakes. Eur J Nutr 2016; 55(3): 1089–1097
https://doi.org/10.1007/s00394-015-0923-0
pmid: 25971845
|
46 |
Tsuboi N, Utsunomiya Y, Kanzaki G , Koike K , Ikegami M , Kawamura T , Hosoya T . Low glomerular density with glomerulomegaly in obesity-related glomerulopathy. Clin J Am Soc Nephrol 2012; 7(5): 735–741
https://doi.org/10.2215/CJN.07270711
pmid: 22403274
|
47 |
Praga M, Hernández E, Morales E , Campos AP , Valero MA , Martínez MA , León M . Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant 2001; 16(9): 1790–1798
https://doi.org/10.1093/ndt/16.9.1790
pmid: 11522860
|
48 |
Chen HM, Chen Y, Zhang YD , Zhang PP , Chen HP , Wang QW , Li LS, Liu ZH. Evaluation of metabolic risk marker in obesity-related glomerulopathy. J Ren Nutr 2011; 21(4): 309–315
https://doi.org/10.1053/j.jrn.2010.06.019
pmid: 20833076
|
49 |
Tsuboi N, Koike K, Hirano K , Utsunomiya Y , Kawamura T , Hosoya T . Clinical features and long-term renal outcomes of Japanese patients with obesity-related glomerulopathy. Clin Exp Nephrol 2013; 17(3): 379–385
https://doi.org/10.1007/s10157-012-0719-y
pmid: 23135866
|
50 |
Praga M, Borstein B, Andres A , Arenas J , Oliet A , Montoyo C , Ruilope LM , Rodicio JL . Nephrotic proteinuria without hypoalbuminemia: clinical characteristics and response to angiotensin-converting enzyme inhibition. Am J Kidney Dis 1991; 17(3): 330–338
https://doi.org/10.1016/S0272-6386(12)80483-5
pmid: 1996578
|
51 |
Praga M, Morales E, Herrero JC , Pérez Campos A , Domínguez-Gil B , Alegre R , Vara J, Martínez MA. Absence of hypoalbuminemia despite massive proteinuria in focal segmental glomerulosclerosis secondary to hyperfiltration. Am J Kidney Dis 1999; 33(1): 52–58
https://doi.org/10.1016/S0272-6386(99)70257-X
pmid: 9915267
|
52 |
Sethi S, Zand L, Nasr SH , Glassock RJ , Fervenza FC . Focal and segmental glomerulosclerosis: clinical and kidney biopsy correlations. Clin Kidney J 2014; 7(6): 531–537
https://doi.org/10.1093/ckj/sfu100
pmid: 25503953
|
53 |
Sethi S, Glassock RJ, Fervenza FC . Focal segmental glomerulosclerosis: towards a better understanding for the practicing nephrologist. Nephrol Dial Transplant 2015; 30(3): 375–384
https://doi.org/10.1093/ndt/gfu035
pmid: 24589721
|
54 |
Salvatore SP, Chevalier JM, Kuo SF , Audia PF , Seshan SV . Kidney disease in patients with obesity: It is not always obesity-related glomerulopathy alone. Obes Res Clin Pract2017 Apr 22. [Epub ahead of print] doi: 10.1016/j.orcp.2017.04.003
https://doi.org/10.1016/j.orcp.2017.04.003
pmid: 28442280
|
55 |
Saiki A, Nagayama D, Ohhira M , Endoh K , Ohtsuka M , Koide N , Oyama T , Miyashita Y , Shirai K . Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy. Int J Obes 2005; 29(9): 1115–1120
https://doi.org/10.1038/sj.ijo.0803009
pmid: 15925953
|
56 |
Bolignano D, Zoccali C. Effects of weight loss on renal function in obese CKD patients: a systematic review. Nephrol Dial Transplant 2013; 28(Suppl 4): iv82–iv98
https://doi.org/10.1093/ndt/gft302
pmid: 24092846
|
57 |
Friedman AN, Chambers M, Kamendulis LM , Temmerman J . Short-term changes after a weight reduction intervention in advanced diabetic nephropathy. Clin J Am Soc Nephrol 2013; 8(11): 1892–1898
https://doi.org/10.2215/CJN.04010413
pmid: 23929927
|
58 |
Morales E, Valero MA, León M , Hernández E , Praga M . Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Am J Kidney Dis 2003; 41(2): 319–327
https://doi.org/10.1053/ajkd.2003.50039
pmid: 12552492
|
59 |
Afshinnia F, Wilt TJ, Duval S , Esmaeili A , Ibrahim HN . Weight loss and proteinuria: systematic review of clinical trials and comparative cohorts. Nephrol Dial Transplant 2010; 25(4): 1173–1183
https://doi.org/10.1093/ndt/gfp640
pmid: 19945950
|
60 |
Serra A, Esteve A, Navarro-Díaz M, López D , Bancu I , Romero R . Long-term normal renal function after drastic weight reduction in patients with obesity-related glomerulopathy. Obes Facts 2015; 8(3): 188–199
https://doi.org/10.1159/000431027
pmid: 25968610
|
61 |
Schauer PR, Bhatt DL, Kirwan JP , Wolski K , Brethauer SA , Navaneethan SD , Aminian A , Pothier CE , Kim ES, Nissen SE, Kashyap SR; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med 2014; 370(21): 2002–2013
https://doi.org/10.1056/NEJMoa1401329
pmid: 24679060
|
62 |
MacLaughlin HL, Hall WL, Patel AG , M acdougall IC . Laparoscopic sleeve gastrectomy is a novel and effective treatment for obesity in patients with chronic kidney disease. Obes Surg 2012; 22(1): 119–123
https://doi.org/10.1007/s11695-011-0448-4
pmid: 21611875
|
63 |
Neff KJ, Frankel AH, Tam FW , Sadlier DM , Godson C , le Roux CW . The effect of bariatric surgery on renal function and disease: a focus on outcomes and inflammation. Nephrol Dial Transplant 2013; 28(Suppl 4): iv73–iv82
https://doi.org/10.1093/ndt/gft262
pmid: 24071659
|
64 |
Reid TJ, Saeed S, McCoy S , Osewa AA , Persaud A , Ahmed L . The effect of bariatric surgery on renal function. Surg Obes Relat Dis 2014; 10(5): 808–813
https://doi.org/10.1016/j.soard.2014.02.048
pmid: 25304831
|
65 |
Saleh F, Kim SJ, Okrainec A , Jackson TD . Bariatric surgery in patients with reduced kidney function: an analysis of short-term outcomes. Surg Obes Relat Dis 2015; 11(4): 828–835
https://doi.org/10.1016/j.soard.2014.11.012
pmid: 25868831
|
66 |
Lieske JC, Mehta RA, Milliner DS , Rule AD , Bergstralh EJ , Sarr MG . Kidney stones are common after bariatric surgery. Kidney Int 2015; 87(4): 839–845
https://doi.org/10.1038/ki.2014.352
pmid: 25354237
|
67 |
Mallamaci F, Ruggenenti P, Perna A , Leonardis D , Tripepi R , Tripepi G , Remuzzi G , Zoccali C; REIN Study Group . ACE inhibition is renoprotective among obese patients with proteinuria. J Am Soc Nephrol 2011; 22(6): 1122–1128
https://doi.org/10.1681/ASN.2010090969
pmid: 21527660
|
68 |
Patil MR, Mishra A, Jain N , Gutch M , Tewari R . Weight loss for reduction of proteinuria in diabetic nephropathy: comparison with angiotensin-converting enzyme inhibitor therapy. Indian J Nephrol 2013; 23(2): 108–113
https://doi.org/10.4103/0971-4065.109412
pmid: 23716916
|
69 |
Miyazaki Y, Cersosimo E, Triplitt C , DeFronzo RA . Rosiglitazone decreases albuminuria in type 2 diabetic patients. Kidney Int 2007; 72(11): 1367–1373
https://doi.org/10.1038/sj.ki.5002516
pmid: 17805239
|
70 |
Zhang SQ, Sun YT, Xu TH , Zhang XF , Liu YZ, Ma MJ, Wang LN , Yao L. Protective effect of metformin on renal injury of C57BL/6J mouse treated with high fat diet. Pharmazie 2014; 69(12): 904–908
pmid: 25951664
|
71 |
Birk AV, Chao WM, Bracken C , Warren JD , Szeto HH . Targeting mitochondrial cardiolipin and the cytochrome c/cardiolipin complex to promote electron transport and optimize mitochondrial ATP synthesis. Br J Pharmacol 2014; 171(8): 2017–2028
https://doi.org/10.1111/bph.12468
pmid: 24134698
|
72 |
Pierine DT, Navarro ME, Minatel IO , Luvizotto RA , Nascimento AF , Ferreira AL , Yeum KJ , Corrêa CR . Lycopene supplementation reduces TNF- a via RAGE in the kidney of obese rats. Nutr Diabetes 2014; 4(11): e142
https://doi.org/10.1038/nutd.2014.39
pmid: 25383746
|
73 |
Stacchiotti A, Favero G, Giugno L , Lavazza A , Reiter RJ , Rodella LF , Rezzani R . Mitochondrial and metabolic dysfunction in renal convoluted tubules of obese mice: protective role of melatonin. PLoS One 2014; 9(10): e111141. DOI:10.1371/journal. pone. 0111141
|
74 |
Wang C, Wu M, Arvapalli R , Dai X, Mahmood M, Driscoll H , Rice KM , Blough E . Acetaminophen attenuates obesity-related renal injury through ER-mediated stress mechanisms. Cell Physiol Biochem 2014; 33(4): 1139–1148
https://doi.org/10.1159/000358683
pmid: 24731963
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|