Abstract

MARTINS, Ana Rita  and  MAS, Sebastian. Lipotoxicity and kidney. Port J Nephrol Hypert [online]. 2015, vol.29, n.4, pp.306-315. ISSN 0872-0169.

Lipotoxicity could be defined as the deleterious effects exerted by lipids on plasma (normally as nonesterified molecules) on cell and tissues. Lipotoxicity is closely linked to obesity, although it can be observed in some lean individuals. Therefore, as overweight becomes more prevalent worldwide, the pathological effects mediated by lipotoxic molecules will have a greater impact in healthcare systems. Ectopic deposition of lipids into non-adipose tissues, such as the kidney, can lead to accumulation of toxic metabolites that lead to mitochondrial dysfunction, endoplasmic reticulum stress, apoptosis and renal dysfunction. Pro-inflammatory mediators are released by visceral adipose tissue in response to injury: adipocytokines (leptin, resistin, vistatin, adiponectin), chemokines (IP-10, IL-8, RANTES and MCP-1), interleukins (IL-1, IL-6) and growth factors (TNFa). Visceral adiposity plays an important role in inflammation and insulin resistance in obesity. Oxidative processes are pivotal events in injury to renal tubular and epithelial cells exposed to ox-LDL. In type 2 diabetes, ox-LDL and free fatty acids damage podocyte function, structure and tubulointersticial tissue. The mechanisms by which obesity causes nephron injury are not fully understood but likely involve a combination of haemodynamic, metabolic and inflammatory changes. Most of the research has been done on its effects in cardiovascular disease, but lipotoxicity is also a major contributor to the development of chronic kidney disease (CKD). The understanding of the adipogenesis should provide new opportunities for therapeutic intervention. In this paper the current state of causes, consequences and possible therapeutic intervention is summarized, providing an insight on the contribution of lipotoxic molecules to renal disease

Keywords : Lipotoxicity; obesity; visceral adipose tissue; adipocytokines; insulin resistance.

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