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. 1975 Oct;81(1):117–130.

Massive obesity and the kidney. A morphologic and statistical study.

A H Cohen
PMCID: PMC2032303  PMID: 1180328

Abstract

The renal morphology of 5 grossly obese patients with normal renal function and many of the features of the Pickwickian syndrome was studied at autopsy. The most striking feature was that of increased glomerular size. Measurements of two parameters of glomerular areas indicated statistically significant glomerular enlargement for both as compared to controls. Glomerulomegaly was primarily the result of vascular dilatation and a variable mesangial component. This abnormality was related to several factors, including increased blood volume, hypoxia, and increased right ventricular pressure. Polycythemia, commonly noted in other similar conditions with glomerulomegaly, is believed to be of no importance in the pathogenesis of glomerular enlargement.

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Selected References

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  1. ALEXANDER J. K., DENNIS E. W., SMITH W. G., AMAD K. H., DUNCAN W. C., AUSTIN R. C. Blood volume, cardiac output, and distribution of systemic blood flow in extreme obesity. Cardiovasc Res Cent Bull. 1962;1:39–44. [PubMed] [Google Scholar]
  2. BAUER W. C., ROSENBERG B. F. A quantitative study of glomerular enlargement in children with tetralogy of Fallot. A condition of glomerular enlargement without an increase in renal mass. Am J Pathol. 1960 Dec;37:695–712. [PMC free article] [PubMed] [Google Scholar]
  3. BICKELMANN A. G., BURWELL C. S., ROBIN E. D., WHALEY R. D. Extreme obesity associated with alveolar hypoventilation; a Pickwickian syndrome. Am J Med. 1956 Nov;21(5):811–818. doi: 10.1016/0002-9343(56)90094-8. [DOI] [PubMed] [Google Scholar]
  4. CORRIN B. Glomerular size in polycythaemia. J Pathol Bacteriol. 1961 Oct;82:534–535. [PubMed] [Google Scholar]
  5. COUNIHAN T. B. Heart failure due to extreme obesity. Br Heart J. 1956 Jul;18(3):425–426. doi: 10.1136/hrt.18.3.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. ELLIS P. A. Renal enlargement in chronic cor pulmonale. J Clin Pathol. 1961 Sep;14:552–556. doi: 10.1136/jcp.14.5.552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. HACKNEY J. D., CRANE M. G., COLLIER C. C., ROKAW S., GRIGGS D. E. Syndrome of extreme obesity and hypoventilation: studies of etiology. Ann Intern Med. 1959 Sep;51:541–552. doi: 10.7326/0003-4819-51-3-541. [DOI] [PubMed] [Google Scholar]
  8. HAMBURGER J., MERY J. P., GUERRA L. [Clinical study on the relation between the kidney and polyglobulia]. Nouv Rev Fr Hematol. 1961 May-Jun;1:503–518. [PubMed] [Google Scholar]
  9. Hall B. D., Smith D. W. Prader-Willi syndrome. A resumé of 32 cases including an instance of affected first cousins, one of whom is of normal stature and intelligence. J Pediatr. 1972 Aug;81(2):286–293. doi: 10.1016/s0022-3476(72)80297-x. [DOI] [PubMed] [Google Scholar]
  10. Hutchins G. M., Kutchemeshgi A. D. Renal glomerular enlargement in chronic passive congestion. Johns Hopkins Med J. 1973 May;132(5):292–300. [PubMed] [Google Scholar]
  11. Ingelfinger J. R., Kissane J. M., Robson A. M. Glomerulomegaly in a patient with cyanotic congenital heart disease. Am J Dis Child. 1970 Jul;120(1):69–71. doi: 10.1001/archpedi.1970.02100060103017. [DOI] [PubMed] [Google Scholar]
  12. MALIZIA E. Renal function and hemodynamics in primary and secondary polycythemia. Acta Med Scand. 1956 Jun 9;154(5):399–406. doi: 10.1111/j.0954-6820.1956.tb14336.x. [DOI] [PubMed] [Google Scholar]
  13. MEESSEN H., LITTON M. A. Morphology of the kidney in morbus caeruleus. AMA Arch Pathol. 1953 Nov;56(5):480–487. [PubMed] [Google Scholar]
  14. NAEYE R. L. CHILDREN AT HIGH ALTITUDE: PULMONARY AND RENAL ABNORMALITIES. Circ Res. 1965 Jan;16:33–38. doi: 10.1161/01.res.16.1.33. [DOI] [PubMed] [Google Scholar]
  15. NAEYE R. L. Human intrauterine parabiotic syndrome and its complications. N Engl J Med. 1963 Apr 11;268:804–809. doi: 10.1056/NEJM196304112681502. [DOI] [PubMed] [Google Scholar]
  16. Rochester D. F., Enson Y. Current concepts in the pathogenesis of the obesity-hypoventilation syndrome. Mechanical and circulatory factors. Am J Med. 1974 Sep;57(3):402–420. doi: 10.1016/0002-9343(74)90135-1. [DOI] [PubMed] [Google Scholar]
  17. Rosenmann E., Dwarka L., Boss J. H. Proliferative glomerulopathy in rheumatic heart disease and chronic lung disease. Am J Med Sci. 1972 Sep;264(3):213–223. [PubMed] [Google Scholar]
  18. SPEAR G. S. Glomerular alterations in cyanotic congenital heart disease. Bull Johns Hopkins Hosp. 1960 Jun;106:347–367. [PubMed] [Google Scholar]
  19. SPEAR G. S., KIHARA I. THE GLOMERULUS IN CYANOTIC CONGENITAL HEART DISEASE: AN IMMUNOFLUORESCENT STUDY. Bull Johns Hopkins Hosp. 1964 Dec;115:481–493. [PubMed] [Google Scholar]
  20. Spear G. S., Vitsky B. H. Hyalinization of afferent and efferent glomerular arterioles in cyanotic congenital heart disease. Am J Med. 1966 Aug;41(2):309–315. doi: 10.1016/0002-9343(66)90025-8. [DOI] [PubMed] [Google Scholar]
  21. Watanabe T., Tanaka K. [Renal changes in cyanotic congenital heart diseases]. Jpn Circ J. 1969 Mar;33(3):313–322. doi: 10.1253/jcj.33.313. [DOI] [PubMed] [Google Scholar]
  22. Weisinger J. R., Kempson R. L., Eldridge F. L., Swenson R. S. The nephrotic syndrome: a complication of massive obesity. Ann Intern Med. 1974 Oct;81(4):440–447. doi: 10.7326/0003-4819-81-4-440. [DOI] [PubMed] [Google Scholar]

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