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2018, Número S1

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Acta Med 2018; 16 (S1)


Obesidad y daño renal

Peña RJC

Idioma: Español
Referencias bibliográficas: 69
Paginas: 32-40
Archivo PDF: 203.80 Kb.


RESUMEN

La obesidad es la epidemia del siglo XXI y produce, entre otros problemas, daño renal. México está entre los países con mayor incidencia de obesidad; los orígenes son recientes y ligados a cambios sustanciales en nuestros hábitos alimentarios y al sedentarismo. El aumento de masa grasa no solo genera daño renal indirectamente a través de la aparición de hipertensión arterial, ateroesclerosis y diabetes mellitus tipo 2, sino también de manera directa con padecimientos como la glomerulosclerosis focal con síndrome nefrótico, nefrosclerosis y fibrosis tubulointersticial. Como describimos, el diagnóstico de obesidad no solo debe basarse en el índice de masa corporal (IMC), sino también en la distribución de la grasa, ya que la grasa visceral conlleva un mayor riesgo de daño multiorgánico y múltiples comorbilidades. Para esto, métodos diagnósticos como el IMC, la relación cintura-cadera y el índice cónico y la bioimpedancia permiten establecer la presencia de sobrepeso y obesidad, así como su distribución corporal. Se analizan todos los factores que conducen al desarrollo de obesidad y daño renal tanto directos como indirectos, los tratamientos de la obesidad y sus efectos sobre la progresión del daño renal y qué incluyen, no solo el tratamiento conservador y farmacológico, sino también la cirugía bariátrica y sus resultados; asimismo, de qué manera incide la obesidad en los resultados del trasplante renal, y finalmente, las ventajas, desventajas y supervivencia en hemodiálisis del paciente con sobrepeso u obesidad.


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