Metabolic kidney disease: a new concept in the interaction between Obesity, Prediabetes, Diabetes and Liver Dysfunction

datacite.rightshttp://purl.org/coar/access_right/c_abf2
dc.contributor.authorRico Fontalvo, Jorge
dc.contributor.authorDaza Arnedo, Rodrigo
dc.contributor.authorRaad Sarabia, María
dc.contributor.authorJiménez, Javier
dc.contributor.authorMontejo-Hernández, Juan
dc.contributor.authorRodríguez-Yánez, Tomas
dc.contributor.authorJosé Soler, María
dc.contributor.authorSciarrone-Alibrandi, Maria Teresa
dc.contributor.authorFernando Rivera, Rodolfo
dc.date.accessioned2026-03-17T22:11:24Z
dc.date.available2026-03-17T22:11:24Z
dc.date.issued2026
dc.description.abstractMetabolic abnormalities such as obesity, insulin resistance, prediabetes, type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD) increasingly contribute to chronic kidney disease (CKD). Although often treated as separate entities, these conditions share common mechanisms – including glomerular hyperfiltration, adipokine imbalance, chronic low-grade inflammation, endothelial dysfunction and lipid accumulation – that initiate and sustain renal injury long before classical CKD becomes clinically evident. The concept of Metabolic Kidney Disease (MKD) offers a unified framework that captures the continuum of renal involvement across the metabolic spectrum. Obesity- and prediabetes-related MKD frequently precede diabetic kidney disease, while MASLD – according to updated EASL-EASD-EASO guidelines – is a multisystem disorder with direct renal consequences. Mixed metabolic phenotypes further intensify metabolic stress, accelerating progression toward CKD. Recognising MKD has important clinical implications. Expanded screening strategies may identify early renal alterations in individuals with metabolic vulnerability who are not targeted by traditional CKD criteria. Integrating metabolic evaluation into nephrology practice may facilitate earlier, more holistic interventions and ultimately improve cardio-renal outcomes.eng
dc.format.mimetypepdf
dc.identifier.doi10.69097/43-01-2026-06
dc.identifier.issn17245990 (electrónico)
dc.identifier.urihttps://hdl.handle.net/20.500.12442/17419
dc.identifier.urlhttps://giornaleitalianodinefrologia.it/wp-content/uploads/sites/3/2026/02/43-01-2026-06.pdf?x16320
dc.language.isoeng
dc.publisherSocietà Italiana di NefrologiaIta
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.sourceGiornale Italiano di NefrologiaIta
dc.sourceG Ital NefrolIta
dc.sourceVol. 1 No. 43 Año 2026 spa
dc.subject.keywordsObesityeng
dc.subject.keywordsType 2 diabeteseng
dc.subject.keywordsPrediabeteseng
dc.subject.keywordsChronic Kidney Diseaseeng
dc.subject.keywordsLiver dysfunctioneng
dc.subject.keywordsCardiorenal metabolic syndromeeng
dc.subject.keywordsAlbuminuriaeng
dc.subject.keywordsGlomerular hyperfiltrationeng
dc.titleMetabolic kidney disease: a new concept in the interaction between Obesity, Prediabetes, Diabetes and Liver Dysfunctioneng
dc.type.driverinfo:eu-repo/semantics/article
dc.type.spaArtículo científico
dcterms.referencesNCD Countdown 2030 collaborators. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet Lond Engl. 22 settembre 2018;392(10152):1072–88.eng
dcterms.referencesKovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. aprile 2022;12(1):7–11.eng
dcterms.referencesLucas B, Taal MW. Epidemiology and causes of chronic kidney disease. Medicine (Baltimore). 1 marzo 2023;51(3):165–9. https://doi.org/10.1016/j.mpmed.2022.12.003.eng
dcterms.referencesNCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet Lond Engl. novembre 2024;404(10467):2077–93. https://doi.org/10.1016/s0140-6736(24)02317-1.eng
dcterms.referencesDía mundial de la diabetes 2024 [Internet]. Cuenta de Alto Costo. [citato 1 dicembre 2025]. Disponibile su: https://cuentadealtocosto.org/noticias/dia-mundial-de-la-diabetes-2024/eng
dcterms.referencesSaid S, Hernandez GT. The link between chronic kidney disease and cardiovascular disease. J Nephropathol. luglio 2014;3(3):99–104. https://doi.org/10.12860/jnp.2014.19.eng
dcterms.referencesDunlay SM, Givertz MM, Aguilar D, Allen LA, Chan M, Desai AS, et al. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circulation. 13 agosto 2019;140(7):e294–324. https://doi.org/10.1161/cir.0000000000000691.eng
dcterms.referencesGonzález-Robledo G, Jaramillo Jaramillo M, Comín-Colet J. Diabetes mellitus, insuficiencia cardiaca y enfermedad renal crónica. Rev Colomb Cardiol. marzo 2020;27:3–6. https://doi.org/10.1016/j.rccar.2019.12.009.eng
dcterms.referencesCobo Marcos M, de la Espriella R, Gayán Ordás J, Llàcer P, Pomares A, Fort A, et al. Prevalence and clinical profile of kidney disease in patients with chronic heart failure. Insights from the Spanish cardiorenal registry. Rev Espanola Cardiol Engl Ed. gennaio 2024;77(1):50–9. https://doi.org/10.1016/j.rec.2023.05.003.eng
dcterms.referencesLaffin LJ, Bakris GL. Intersection Between Chronic Kidney Disease and Cardiovascular Disease. Curr Cardiol Rep. 16 luglio 2021;23(9):117. https://doi.org/10.1007/s11886-021-01546-8.eng
dcterms.referencesMoreno-Pérez O, Reyes-García R, Modrego-Pardo I, López-Martínez M, Soler MJ. Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease? Clin Kidney J. aprile 2024;17(4):sfae039. https://doi.org/10.1093/ckj/sfae039.eng
dcterms.referencesNdumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, et al. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association. Circulation. 14 novembre 2023;148(20):1636–64. https://doi.org/10.1161/CIR.0000000000001186.eng
dcterms.referencesGarcía-Carrasco A, Izquierdo-Lahuerta A, Medina-Gómez G. The Kidney-Heart Connection in Obesity. Nephron. 2021;145(6):604–8. https://doi.org/10.1159/000515419.eng
dcterms.referencesZoccali C, Mallamaci F. The cardiovascular-renal link and the health burden of kidney failure. Eur Heart J. 1 aprile 2023;44(13):1167–9. https://doi.org/10.1093/eurheartj/ehad039.eng
dcterms.referencesRangaswami J, Bhalla V, Blair JEA, Chang TI, Costa S, Lentine KL, et al. Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association. Circulation. 16 aprile 2019;139(16):e840–78. https://doi.org/10.1161/cir.0000000000000664.eng
dcterms.referencesLawson CA, Seidu S, Zaccardi F, McCann G, Kadam UT, Davies MJ, et al. Outcome trends in people with heart failure, type 2 diabetes mellitus and chronic kidney disease in the UK over twenty years. EClinicalMedicine. Febbraio 2021;32:100739. https://doi.org/10.1016/j.eclinm.2021.100739.eng
dcterms.referencesCases A, Broseta JJ, Marqués M, Cigarrán S, Julián JC, Alcázar R, et al. Cardiovascular-kidney-metabolic syndrome definition and its role in the prevention, risk staging, and treatment. An opportunity for the Nephrology. Nefrologia. 2024;44(6):771–83. https://doi.org/10.1016/j.nefroe.2024.11.011.eng
dcterms.referencesNdumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 14 novembre 2023;148(20):1606–35. https://doi.org/10.1161/CIR.0000000000001184.eng
dcterms.referencesClark B, Mulrooney M, Miao B, Kataria D, Kulkarni A, Skaar JR. Defining Cardio-renal-metabolic (CRM) Syndrome: A Targeted Literature Review. Metab – Clin Exp [Internet]. 1 giugno 2024 [citato 1 dicembre 2025];153. https://doi.org/10.1016/j.metabol.2024.155856.eng
dcterms.referencesGarofalo C, Borrelli S, Minutolo R, Chiodini P, De Nicola L, Conte G. A systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population. Kidney Int. maggio 2017;91(5):1224–35. https://doi.org/10.1016/j.kint.2016.12.013.eng
dcterms.referencesTuttle KR, Alicic RZ, Duru OK, Jones CR, Daratha KB, Nicholas SB, et al. Clinical Characteristics of and Risk Factors for Chronic Kidney Disease Among Adults and Children: An Analysis of the CURE-CKD Registry. JAMA Netw Open. 2 dicembre 2019;2(12):e1918169. https://doi.org/10.1001/jamanetworkopen.2019.18169.eng
dcterms.referencesRico-Fontalvo J, Daza-Arnedo R, Rodríguez-Yanez T, Osorio W, Suarez-Romero B, Soto O, et al. Obesidad y enfermedad renal crónica. Una mirada desde los mecanismos fisiopatológicos. Revisión narrativa. Rev Soc Ecuat Nefrol Diálisis Traspl. 30 settembre 2022;10(2):97–107. http://doi.org/10.56867/32.eng
dcterms.referencesWada J, Makino H. Inflammation and the pathogenesis of diabetic nephropathy. Clin Sci Lond Engl 1979. febbraio 2013;124(3):139–52. https://doi.org/10.1042/cs20120198.eng
dcterms.referencesVallon V, Thomson SC. Targeting renal glucose reabsorption to treat hyperglycaemia: the pleiotropic effects of SGLT2 inhibition. Diabetologia. febbraio 2017;60(2):215–25. https://doi.org/10.1007/s00125-016-4157-3.eng
dcterms.referencesBrambilla Pisoni M, Catania M, Rivera RF, De Rosa LI, Kola K, Paolisi M, et al. The Hidden Iceberg of ADPKD: Early Organomegaly-Driven Malnutrition and Sarcopenia Beyond Preserved eGFR. Int J Mol Sci. 2026;27(4):1667. https://doi.org/10.3390/ijms27041667eng
dcterms.referencesAlibrandi MTS, Pisoni MB, Rivera RF, Catania M, Vespa M, De Rosa LI, et al. Body water distribution, early malnutrition and sarcopenia in ADPKD: insights from a cross sectional study. J Nephrol. 2025;38(7):1917–25. https://doi.org/10.1007/s40620-025-02327-0.eng
dcterms.referencesCatania M, Vezzoli G, Sciarrone Alibrandi MT. Highlighting the impact of hormonal factors on hepatic cystogenesis: Implications for pathophysiology and clinical practice. J Hepatol. 2025;82(4):e180–1. https://doi.org/10.1016/j.jhep.2024.09.041.eng
dcterms.referencesPetrone M, Catania M, De Rosa LI, Degliuomini RS, Kola K, Lupi C, et al. Role of Female Sex Hormones in ADPKD Progression and a Personalized Approach to Contraception and Hormonal Therapy. J Clin Med. 2024;13(5):1257. https://doi.org/10.3390/jcm13051257.eng
dcterms.referencesDelli Zotti GB, Sangiovanni E, Brioni E, Ratti MM, Sciarrone Aliprandi MT, Spotti D, et al. [Psychological Assessment of a sample of women with ADPKD: quality of life, body image, anxiety and depression]. G Ital Nefrol Organo Uff Della Soc Ital Nefrol. 2019;36(2):2019-vol2. PubMed PMID: 30983181.eng
dcterms.referencesRivera RF, Alibrandi MTS, Di Lullo L, Fioccari F. Clinical management of anemia in patients with CKD. G Ital Nefrol. 2017;34(Suppl 69):20–35. PubMed PMID: 28682026.eng
dcterms.referencesRivera RF, Guido D, Del Vecchio L, Corghi E, D’Amico M, Camerini C, et al. Impact of European medicines agency recommendations for hypersensitivity reactions on intravenous iron prescription in haemodialysis centres of the Lombardy region. J Nephrol. 2016;29(5):673–81. https://doi.org/10.1007/s40620-015-0254-5. PubMed PMID: 26715394eng
dcterms.referencesRivera RF, Sciarrone Alibrandi MT, Foligno NE, Magagnoli L, Ciceri P, Cozzolino M. Uremic Toxin-Driven Vascular Calcification in Chronic Kidney Disease: Molecular Pathways and Integrated Phenotypes. Toxins. 2026;18(2):112. https://doi.org/10.3390/toxins18020112. PubMed PMID: 41745778; PubMed Central PMCID: PMC12944978.eng
dcterms.referencesVijay K, Neuen BL, Lerma EV. Heart Failure in Patients with Diabetes and Chronic Kidney Disease: Challenges and Opportunities. Cardiorenal Med. 2022;12(1):1–10. https://doi.org/10.1159/000520909.eng
dcterms.referencesSvačina Š. [Obesity and cardiovascular disease]. Vnitr Lek. 2020 Spring;66(2):89-91. Czech. PMID: 32942882.eng
dcterms.referencesHall JE, Mouton AJ, da Silva AA, Omoto ACM, Wang Z, Li X, et al. Obesity, kidney dysfunction, and inflammation: interactions in hypertension. Cardiovasc Res. 7 luglio 2021;117(8):1859–76. https://doi.org/10.1093/cvr/cvaa336.eng
dcterms.referencesYim HE, Yoo KH. Obesity and chronic kidney disease: prevalence, mechanism, and management. Clin Exp Pediatr. ottobre 2021;64(10):511–8. https://doi.org/10.3345/cep.2021.00108.eng
dcterms.referencesStasi A, Cosola C, Caggiano G, Cimmarusti MT, Palieri R, Acquaviva PM, et al. Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management. Front Nutr. 2022;9:925619. https://doi.org/10.3389/fnut.2022.925619.eng
dcterms.referencesTsuboi N, Okabayashi Y. The Renal Pathology of Obesity: Structure-Function Correlations. Semin Nephrol. luglio 2021;41(4):296–306. https://doi.org/10.1016/j.semnephrol.2021.06.002.eng
dcterms.referencesTsuboi N, Okabayashi Y, Shimizu A, Yokoo T. The Renal Pathology of Obesity. Kidney Int Rep. marzo 2017;2(2):251–60. https://doi.org/10.1016/j.ekir.2017.01.007.eng
dcterms.referencesHerman-Edelstein M, Weinstein T, Chagnac A. Obesity-Related Glomerulopathy: Clinical Management. Semin Nephrol. luglio 2021;41(4):358–70. https://doi.org/10.1016/j.semnephrol.2021.06.007.eng
dcterms.referencesChoung HYG, Bomback AS, Stokes MB, Santoriello D, Campenot ES, Batal I, et al. The spectrum of kidney biopsy findings in patients with morbid obesity. Kidney Int. marzo 2019;95(3):647–54. https://doi.org/10.1016/j.kint.2018.11.026.eng
dcterms.referencesD’Agati VD, Chagnac A, de Vries APJ, Levi M, Porrini E, Herman-Edelstein M, et al. Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol. agosto 2016;12(8):453–71. https://doi.org/10.1038/nrneph.2016.75.eng
dcterms.referencesAmerican Diabetes Association Professional Practice Committee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2025. Diabetes Care. 1 gennaio 2025;48(1 Suppl 1):S27–49.eng
dcterms.referencesKim GS, Oh HH, Kim SH, Kim BO, Byun YS. Association between prediabetes (defined by HbA1C, fasting plasma glucose, and impaired glucose tolerance) and the development of chronic kidney disease: a 9-year prospective cohort study. BMC Nephrol. 16 aprile 2019;20(1):130.eng
dcterms.referencesRico Fontalvo J, Soler MJ, Daza Arnedo R, Navarro-Blackaller G, Medina-González R, Rodríguez Yánez T, et al. Prediabetes and CKD: Does a causal relationship exist. Nefrologia. 2024;44(5):628–38. https://doi.org/10.1016/j.nefro.2024.06.008.eng
dcterms.referencesEchouffo-Tcheugui JB, Narayan KM, Weisman D, Golden SH, Jaar BG. Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabet Med J Br Diabet Assoc. dicembre 2016;33(12):1615–24. https://doi.org/10.1111/dme.13113.eng
dcterms.referencesLin L, Lu J, Chen L, Mu Y, Ye Z, Liu C, et al. Glycemic status and chronic kidney disease in Chinese adults: Findings from the REACTION study. J Diabetes. Settembre 2017;9(9):837–45. https://doi.org/10.1111/1753-0407.12490.eng
dcterms.referencesGarcía-Carro C, Vergara A, Bermejo S, Azancot MA, Sellarés J, Soler MJ. A Nephrologist Perspective on Obesity: From Kidney Injury to Clinical Management. Front Med. 2021;8:655871. https://doi.org/10.3389/fmed.2021.655871.eng
dcterms.referencesKidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. aprile 2024;105(4S):S117–314. https://doi.org/10.1016/j.kint.2023.10.018.eng
dcterms.referencesMosquera EY, Montejo Hernández JD, Chacón Acevedo KR, Daza R, De La Espriella-Badel V, Machacón Miranda E, et al. Update of the Colombian clinical practice guideline on diabetic renal disease. Rev Colomb Nefrol [Internet]. 20 novembre 2024. https://doi.org/10.22265/acnef.11.3.912.eng
dcterms.referencesRico Fontalvo JE, Daza Anedo R, Raad Sarabia M, Pájaro Galvis N, Bello Espinosa A, Uparella Gulfo I, et al. Proteoma urinario en la enfermedad renal diabética. Estado del arte: Urinary proteome in diabetic kidney disease: state of the art. Rev Colomb Nefrol. 18 agosto 2021;8(3):e546. https://doi.org/10.22265/acnef.8.3.546.spa
dcterms.referencesRico-Fontalvo J, Aroca-Martinez G, Daza-Arnedo R, Raad-Sarabia M, Torres J, Pajaro-Galvis N, et al. Artículo de Revisión Enfermedad renal diabética no proteinúrica: Estado del arte Non-proteinuric diabetic kidney disease: State of art. Rev Nefrol Dial Traspl 2022424330-339 [Internet]. [citato 1 dicembre 2025]; Disponibile su: https://www.researchgate.net/publication/366812175_Articulo_de_Revision_Enfermedad_renal_diabetica_no_proteinurica_Estado_del_arte_Non-proteinuric_diabetic_kidney_disease_State_of_art.spa
dcterms.referencesSugahara M, Pak WLW, Tanaka T, Tang SCW, Nangaku M. Update on diagnosis, pathophysiology, and management of diabetic kidney disease. Nephrol Carlton Vic. giugno 2021;26(6):491–500. https://doi.org/10.1111/nep.13860.eng
dcterms.referencesToth-Manikowski S, Atta MG. Diabetic Kidney Disease: Pathophysiology and Therapeutic Targets. J Diabetes Res. 2015;2015:697010. https://doi.org/10.1155/2015/697010.eng
dcterms.referencesJorge RF, Rodrigo DA, Tomas RY, Maria Cristina MA, Jose C, Maria Ximena CB, et al. Inflammation and Diabetic Kidney Disease: New Perspectives. J Biomed Res Environ Sci. luglio 2022;3(7):779–86. https://doi.org/10.37871/jbres1513.eng
dcterms.referencesEuropean Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary. Diabetologia. novembre 2024;67(11):2375–92. https://doi.org/10.1007/s00125-024-06196-3.eng
dcterms.referencesBilson J, Mantovani A, Byrne CD, Targher G. Steatotic liver disease, MASLD and risk of chronic kidney diseaseFegato steatotico, MASLD e rischio di malattia renale cronica. Diabetes Metab. 1 gennaio 2024;50(1):101506. https://doi.org/10.1016/j.diabet.2023.101506.eng
dcterms.referencesLonardo A. Association of NAFLD/NASH, and MAFLD/MASLD with chronic kidney disease: an updated narrative review. Metab Target Organ Damage. 7 aprile 2024;4(2):N/A-N/A. https://doi.org/10.20517/mtod.2024.07.eng
dcterms.referencesMusso G, Gambino R, Tabibian JH, Ekstedt M, Kechagias S, Hamaguchi M, et al. Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis. PLoS Med. luglio 2014;11(7):e1001680. https://doi.org/10.1371/journal.pmed.1001680.eng
dcterms.referencesEuropean Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Obes Facts. 2024;17(4):374–444.eng
dcterms.referencesEuropean Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. settembre 2024;81(3):492–542. https://doi.org/10.1016/j.jhep.2024.04.031.eng
dcterms.referencesMahmoodnia L, Aghadavod E, Beigrezaei S, Rafieian-Kopaei M. An update on diabetic kidney disease, oxidative stress and antioxidant agents. J Ren Inj Prev. 2017;6(2):153–7. https://doi.org/10.15171/jrip.2017.30.eng
dcterms.referencesBenlloch S, Moncho F, Górriz JL. Esteatosis hepática metabólica y nefropatía diabética: una llamada a la acción. Nefrología. marzo 2024;44(2):129–38. https://doi.org/10.1016/j.nefroe.2024.03.009.spa
dcterms.referencesKhan SS, Coresh J, Pencina MJ, Ndumele CE, Rangaswami J, Chow SL, et al. Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association. Circulation. 12 dicembre 2023;148(24):1982–2004. https://doi.org/10.1161/cir.0000000000001191.eng
oaire.versioninfo:eu-repo/semantics/publishedVersion

Archivos

Bloque original
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
PDF.pdf
Tamaño:
728.66 KB
Formato:
Adobe Portable Document Format
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
381 B
Formato:
Item-specific license agreed upon to submission
Descripción:

Colecciones