Kidney Biopsy Findings and Management of Kidney Diseases in Patients with Class III Obesity: A Single-Center Experience

Abstract

Background: Class III obesity, formerly known as morbid obesity, is a known risk factor for chronic kidney diseases. Due to outdated information suggesting that morbid obesity is a contraindication for kidney biopsy and the misconception that proteinuria in obese patients is solely related to hyperfiltration, necessiating only conservative treatment, the vast majority of primary glomerulonephritis in these patients remains undiagnosed and untreated. Here, the clinical characteristics, treatments and results of patients who had class III obesity and needed a kidney biopsy are presented. Methods: Two hundred thirty-one native kidney biopsies conducted between 2015 and 2021 were retrospectively reviewed, identifying 12 patients with a body mass index ≥40 kg/m2 . Results: Ten patients presented with nephrotic syndrome, 8 of these patients underwent immunosuppressive therapy. Membranous nephropathy and focal segmental glomerulosclerosis were the most common diagnoses. Seven patients went into remission during follow-up. Our results indicated that class III obesity alone is not a detrimental morbidity when it comes to diagnosing and treating glomerular diseases. Conclusion: If a primary glomerulonephritis is diagnosed through a safe biopsy procedure, there is no reason to avoid considering immunosuppressive therapy for these patients.