The Nephrotic Syndrome: A Complication of Massive Obesity

TLDR

The study proposes that reversible proteinuria in massive obesity is due to renal venous hypertension. Four obese patients with nephrotic syndrome were examined. Weight loss reduced proteinuria and was linked to lower right atrial pressure and blood volume, while cardiac output remained high; two patients had mesangial glomerulopathy.

Abstract

Four patients with massive obesity and the nephrotic syndrome were studied. Congestive heart failure was not clinically apparent, and measured cardiac output was elevated; however, right atrial pressure and blood volume were increased. In each case the proteinuria decreased during dietary weight loss. Reductions in right atrial pressure and blood volume also coincided with remission in proteinuria. A mesangial glomerulopathy was present in two patients. We propose that the cause of the reversible proteinuria seen in these obese patients was renal venous hypertension.