{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:07:33Z","timestamp":1792786053392,"version":"4.5.0"},"reference-count":90,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Renal Association","id":[{"id":"https:\/\/ror.org\/01zpyjx73","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Obesity is an important risk factor for chronic kidney disease (CKD), yet only a subset of individuals with obesity develops albuminuria, declining estimated glomerular filtration rate, and progressive kidney disease. This variability indicates that excess body weight alone is insufficient to explain obesity-induced kidney injury. In this review, we propose that cardio\u2013kidney\u2013metabolic (CKM) syndrome provides a useful framework to understand this heterogeneity. We discuss major pathophysiological contributors to kidney vulnerability in obesity, including haemodynamic stress, metabolic toxicity\/insulin resistance, visceral and ectopic fat, inflammation, oxidative stress, adipokine imbalance, and reduced nephron reserve. Several of these contributors converge on a common intrarenal pathway characterized by increased single-nephron workload, maladaptive glomerular hyperfiltration, and intraglomerular hypertension, followed by podocyte stress, albuminuria, and progressive kidney injury. On this basis, we propose a conceptual framework comprising four overlapping CKM-related kidney vulnerability domains, which may help identify individuals at increased CKD risk, support earlier screening and longitudinal monitoring, and inform preventive strategies.<\/jats:p>","DOI":"10.1093\/ndt\/gfag221","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:10:11Z","timestamp":1790334611000},"source":"Crossref","is-referenced-by-count":0,"title":["Obesity and chronic kidney disease: a cardio\u2013kidney\u2013metabolic framework for renal vulnerability and risk stratification"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-1446","authenticated-orcid":false,"given":"Milica","family":"Bozic","sequence":"first","affiliation":[{"name":"Vascular and Renal Translational Research Group, Biomedical Research Institute of Lleida\u2014Dr. Pifarr\u00e9 Foundation , IRBLleida, Lleida ,","place":["Spain"]},{"name":"RICORS2040-Renal Network, ISCIII , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6216-9635","authenticated-orcid":false,"given":"Marieta","family":"Theodorakopoulou","sequence":"additional","affiliation":[{"name":"First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastjan","family":"Bevc","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor , Maribor ,","place":["Slovenia"]},{"name":"Medical Faculty, University of Maribor , Maribor ,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Miglinas","sequence":"additional","affiliation":[{"name":"Center of Nephrology, Santaros Klinikos, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of 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