Range of adiposity and cardiorenal syndrome

Core Tip

Core tip: Visceral adiposity and morbid obesity are risk factors for heart and kidney disease, configuring a cardiorenal syndrome. Adipose tissue results in hemodynamic and mechanical derangements in addition to activating neuro-humoral systems such as endothelial dysfunction, adipokines, renin-angiotensin-aldosterone, sympathetic nervous system, natriuretic peptides, inflammation, and oxidative stress. Obesity induces cardiac remodeling and fibrosis, leading to heart failure (HF). HF with preserved ejection fraction is characteristically linked to obesity. Hyperfiltration, increased glomerular capillary wall tension, podocyte dysfunction, and, finally, chronic kidney disease has been linked to obesity. Most of the new treatments for diabetes mellitus type 2, which have favorable cardiovascular outcomes, improve the cardiometabolic renal syndrome associated with obesity.