Zurita-Cruz JN, Villasís-Keever MÁ

Idioma: Español
Referencias bibliográficas: 41
Paginas: 514-520
Archivo PDF: 86.61 Kb.

RESUMEN

En las últimas décadas, la obesidad y la enfermedad renal crónica (ERC) se han incrementado a nivel mundial de manera paralela. En este artículo se abordan los aspectos actuales de la obesidad sobre el daño renal, con especial énfasis en lo que ocurre en edades pediátricas.
Si bien la obesidad se ha relacionado de forma estrecha con la diabetes mellitus tipo 2 y con la hipertensión arterial sistémica, la reducción de la sensibilidad de insulina es un mecanismo directo para el daño renal. Los mecanismos fisiopatogénicos de la obesidad sobre el daño renal incluyen hiperflitración e hipertrofia glomerular, hipercelularidad y ensanchamiento de las regiones mesangiales, mientras que la falta de sensibilidad a la insulina aumenta los efectos de angiotensina II, agrava la proteinuria e induce la producción de citocinas inflamatorias.
Múltiples estudios epidemiológicos documentan la relación del incremento del índice de masa corporal con el desarrollo de ERC; sin embargo, la mayoría son de población adulta. En niños, la información es limitada pero congruente con los hallazgos en adultos. En contraste, existen estudios donde se observa que las intervenciones enfocadas a la disminución de peso mejoran y limitan el daño renal, ya que se reducen la proteinuria, las cifras de presión arterial y la tasa de filtración glomerular.
Todo lo anterior hace reflexionar sobre la necesidad de mejorar los esfuerzos para disminuir la prevalencia de la obesidad desde etapas tempranas de la vida, lo cual llevará a que en el futuro existan menor número de pacientes con ERC.

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