Clinical Assessment: Renal Issues

Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.

This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.


Obesity is associated with renal risk factors such as hypertension and diabetes, but also with an unfavourable renal hemodynamic profile. This results in both functional (sodium retention, mircroalbuminuria) and morphological (glomerulomegaly, focal segmental glomerulosclerosis) changes that can sometimes produce a progressive fall in glomerular filtration rate and a further rise in urinary albumin excretion. Together, these can lead to the development of proteinuria, and, in rare cases, end-stage renal failure.

In patients with end-stage renal failure, severe obesity may pose a problem for vascular access, and complicate peritoneal dialysis and renal transplantation.

Obesity is also associated with an increased risk for kidney stones and renal cancer.

Excess weight is a recognized risk factor for urinary stress incontinence.

© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.

The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.

Members of the Canadian Obesity Network can download Best Weight for free.

Best Weight is also available at Amazon and Barnes & Nobles (part of the proceeds from all sales go to support the Canadian Obesity Network)

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