{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:13:42Z","timestamp":1792523622895,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,5,17]],"date-time":"2018-05-17T00:00:00Z","timestamp":1526515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO\u20101DK88114"],"award-info":[{"award-number":["RO\u20101DK88114"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Lipodystrophy syndromes are a group of heterogeneous disorders characterized by adipose tissue loss. Proteinuria is a remarkable finding in previous reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>In this multicentre study, prospective follow\u2010up data were collected from 103 subjects with non\u2010<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010associated lipodystrophy registered in the Turkish Lipodystrophy Study Group database to study renal complications in treatment na\u00efve patients with lipodystrophy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Main outcome measures included ascertainment of chronic kidney disease (<jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>) by studying the level of proteinuria and the estimated glomerular filtration rate (<jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content>). Kidney volume was measured. Percutaneous renal biopsies were performed in 9 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen of 37 patients with generalized and 29 of 66 patients with partial lipodystrophy had <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content> characterized by proteinuria, of those 12 progressed to renal failure subsequently. The onset of renal complications was significantly earlier in patients with generalized lipodystrophy. Patients with <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content> were older and more insulin resistant and had worse metabolic control. Increased kidney volume was associated with poor metabolic control and suppressed leptin levels. Renal biopsies revealed thickening of glomerular basal membranes, mesangial matrix abnormalities, podocyte injury, focal segmental sclerosis, ischaemic changes and tubular abnormalities at various levels. Lipid vacuoles were visualized in electron microscopy images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content> is conspicuously frequent in patients with lipodystrophy which has an early onset. Renal involvement appears multifactorial. While poorly controlled diabetes caused by severe insulin resistance may drive the disease in some cases, inherent underlying genetic defects may also lead to cell autonomous mechanisms contributory to the pathogenesis of kidney disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13732","type":"journal-article","created":{"date-parts":[[2018,5,3]],"date-time":"2018-05-03T21:19:32Z","timestamp":1525382372000},"page":"65-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Renal complications of lipodystrophy: A closer look at the natural history of kidney disease"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8634-4845","authenticated-orcid":false,"given":"Baris","family":"Akinci","sequence":"first","affiliation":[{"name":"Division of Endocrinology Department of Internal Medicine Dokuz Eylul University  Izmir 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