الفهرس 
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Abstract
Obesity is a non-transmissible chronic disease, characterized by the excessive accumulation of body fat to such an extent that it causes damages to individuals’ health. Its association with kidney disease is complex. Excess fat is a site of active production of several cytokines responsible for the higher level of inflammation and oxidative stress with deleterious renal effects.
Chronic kidney disease (CKD) is characterized by a reduced estimated glomerular filtration rate (eGFR), increased urinary albumin excretion, or both. It constitutes an increasingly common public health issue, with an estimated worldwide prevalence of 8–16%, and its complications include increased all-cause and cardiovascular mortality, kidney disease progression, acute kidney injury, cognitive decline, anemia, mineral and bone disorders, and fractures.
A consistent association was demonstrated between obesity and the risk of chronic kidney disease (CKD). It was suggested that visceral fat accumulation, estimated using bioelectric impedance analysis, is associated with an increased urinary albumin-creatinine ratio (ACR).
Also, it was found that obesity was significantly related to an increased albumin excretion rate, irrespective of the obesity type. A significant difference in the risk of renal malfunction was observed in individuals with a similar percentage but different distribution of total body fat (BF), with the central fat pattern comprising the greater risk. However, the role of body fat in its development is still unclear.
The present study aimed to investigate the association between obesity and CKD in a sample of Egyptian adult individuals
The present study included 480 individuals and the study population was categorized into two groups:
Obese group included 400 obese individuals
Non- obese group include 80 non-obese individuals.
Exclusion Criteria
- Subjects with a body mass index (BMI) <20,
- Known renal disease,
- Hypertension,
- Diabetes Milletus.
- History of cardiac disease.
- History of liver disease.
All the included patients were subjected to:
Full history taking about relevant medical history and medication.
Clinical examination which includes:
o General: with especial emphasis on weight, height, BMI, waist circumference (WC) and WC to height ratio (WC/H).
o Local: Blood pressure chest, cardiac abdominal examination. Edema lower limb.
Laboratory investigations as:
- HbA1C, FBS , 2 HPPBs
- Serum creatinine (SCr),BUN , Uric Acid , Urine analysis.
- Urinary albumin/creatinine ratio (ACR), and abnormal albuminuria was defined as a urine ACR ≥30 mg/g. All positive cases re-examined after 3 months to confirm diagnosis.
- eGFR by CKD-EPI formula. Hyperfiltration was defined as a GFR of between 125 and 140 mL/min/1.73 m2.
- High sensitivity C-reactive protein (HS-CRP),
- Lipid profile (HDL, low-Density Lipoprotein (LDL), total cholesterol, and TG,
By analyzing and processing the data obtained from the history and examination, the study declared that:
There was no statistically significant differences between obese and non-obese cases regarding age and sex. While there were significant higher mean values of weight, BMI, waist circumference, SBP and DBP in obese than non-obese group.
There wasno statistically significant differences between obese and non-obese cases regardingFasting Blood Glucose, S urea, Uric acid and Alb/Cr (P>0.05). While there were significant higher mean values of 2 hours post prandial blood glucose, HBA1c, S creatinine, CRP, S cholesterol, LDL and TG in obese patients than non-obese group. On the other hands, mean values of eGFR and HDLwere significantly lower in obese than non-obese group.
There was no significant difference between males and females’ obese cases as regards Alb/Cr or eGFR (P>0.05).
There was no significant correlations between Alb/Cr in obese cases and Age, Weight, SBP and DBP. While there was a significant positive correlation between waist circumference with Alb/Cr in obese cases (P<0.05).
There was no significant correlation between Alb/Cr in obese cases and FBG, 2 hours PPBG, HBA1c, Uric acid, LDL and HDL. While there were significant positive correlations between S. creatinine, S urea, CRP, S cholesterol and TG with Alb/Cr in obese cases. While, eGFR was significantly negatively correlated with Alb/Cr in obese cases.
There was no significant correlation between eGFR (ml/min) in obese caseswith age, weight, SBP and DBP. While there was a significant positive correlation between waist circumference with eGFR in obese cases.
There was no significant correlations between eGFR (ml/min) in obese cases withFBG, 2 hours PPBG, HBA1c, Uric acid, CRP, Cholesterol, LDL,HDL and TG. While there were significant negative correlations between S. creatinine, S urea with Alb/Cr with eGFR in obese cases.