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A novel area of research investigates the concept of fatty kidney in the pathogenesis of chronic kidney disease, especially in patients with diabetes mellitus or metabolic syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review the most updated literature on fatty kidney and provide future research, diagnostic and therapeutic perspectives on a disease increasingly affecting the contemporary world.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Method<\/jats:title><jats:p>We performed an extensive literature search through three databases including Embase (Elsevier) and the Cochrane Central Register of Controlled Trials (Wiley) and PubMed\/Medline Web of Science in November 2021 by using the following terms and their combinations: \u2018fatty kidney\u2019, \u2018ectopic fat\u2019, \u2018chronic kidney disease\u2019, \u2018cardiovascular event\u2019, \u2018cardio\u2010metabolic risk\u2019, \u2018albuminuria\u2019 and \u2018metabolic syndrome\u2019. Each study has been individually assessed by the authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Oxidative stress and inflammation, Klotho deficiency, endoplasmic reticulum stress, mitochondrial dysfunction and disruption of cellular energy balance appear to be the main pathophysiological mechanisms leading to tissue damage following fat accumulation. Despite the lack of large\u2010scale comprehensive studies in this novel field of research, current clinical trials demonstrate fatty kidney as an independent risk factor for the development of chronic kidney disease and cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The requirement for future studies investigating the pathophysiology, clinical outcomes and therapeutics of fatty kidney is clear.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13748","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T08:13:49Z","timestamp":1642493629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Fatty kidney: A possible future for chronic kidney disease research"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-0675","authenticated-orcid":false,"given":"Mehmet","family":"Kanbay","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine Koc University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidar","family":"Copur","sequence":"additional","affiliation":[{"name":"Department of Medicine Koc University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-5305","authenticated-orcid":false,"given":"Atalay","family":"Demiray","sequence":"additional","affiliation":[{"name":"Department of Medicine Koc University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan A.","family":"Sag","sequence":"additional","affiliation":[{"name":"Division of Vascular and Interventional Radiology Department of Radiology Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Covic","sequence":"additional","affiliation":[{"name":"Department of Nephrology Grigore T. 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