Pathology of renal complications in obesity.

Morphologic changes in massive obesity in both humans and experiment animals are rather limited. Glomerulomegaly is common and often asymptomatic. Frequently, ensuing focal and segmental glomerulosclerosis may well be related to alterations in intraglomerular hemodynamics and may result in heavy proteinuria. Factors for the occurrence of segmental glomerulosclerosis have been assessed in animal models and include the influence of lipids. A consequence of surgical therapy for obesity (ie, jejunoileal bypass) is oxalosis with chronic interstitial nephritis, and this may necessitate a takedown of the bypass.