{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:55:29Z","timestamp":1792788929811,"version":"4.5.0"},"reference-count":115,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"name":"National Institute of Diabetes and Digestive and Kidney Diseases","award":["R01-DK124138, R01-DK132869, and R01-DK132875"],"award-info":[{"award-number":["R01-DK124138, R01-DK132869, and R01-DK132875"]}],"id":[{"id":"https:\/\/ror.org\/00adh9b73","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Heart, Lung, and Blood Institute","award":["K23HL172699"],"award-info":[{"award-number":["K23HL172699"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"crossref"}]},{"name":"U.S. Department of Veterans Affairs","award":["1I01CX002382"],"award-info":[{"award-number":["1I01CX002382"]}],"id":[{"id":"https:\/\/ror.org\/05rsv9s98","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"<jats:p>\n                    Obesity is a major risk factor for CKD, which contributes to a complex interplay of metabolic, inflammatory, and hemodynamic disturbances that accelerate kidney function decline and heighten cardiovascular risk. Obesity contributes to kidney injury through direct mechanisms, including glomerular hyperfiltration and increased intraglomerular pressure, and indirect pathways mediated by diabetes, hypertension, and cardiovascular\u2013metabolic disease, while also promoting tubular injury. Emerging evidence also suggests that adipose tissue distribution influences end-organ damage, with visceral and ectopic perirenal fat depots linked to CKD. These inter-relationships are corroborated by population-based studies showing that markers of adiposity are associated with higher risk of incident CKD, CKD progression, and ESKD. With the advent of newer therapeutics, the management of obesity in CKD has shifted from a predominantly lifestyle-focused approach to a more comprehensive, multimodal strategy that integrates pharmacologic therapies with established cardiovascular\u2013kidney\u2013metabolic benefits, alongside structured nutritional guidance, individualized physical activity, and sustained behavioral support. Incretin-based therapies, particularly glucagon-like peptide-1 receptor agonists (GLP1ra) and dual incretin agonists, have redefined treatment paradigms by addressing metabolic dysfunction, CKD progression, and cardiovascular risk. Emerging agents, including triple incretin agonists, promise even greater efficacy in weight reduction and metabolic control, although data on efficacy and safety in kidney disease remain limited. Sodium\u2013glucose cotransporter 2 inhibitors also promote modest weight loss, largely through urinary glucose-mediated caloric loss, while providing cardio-kidney protection. With respect to nonpharmacological interventions, clinical studies show bariatric surgery achieves substantial weight loss and is associated with improved cardio-kidney outcomes in CKD. In this review, we examine (\n                    <jats:italic toggle=\"yes\">1<\/jats:italic>\n                    ) the pathophysiology of obesity-induced kidney disease and its cardiometabolic complications, (\n                    <jats:italic toggle=\"yes\">2<\/jats:italic>\n                    ) risk stratification of obesity and CKD, (\n                    <jats:italic toggle=\"yes\">3<\/jats:italic>\n                    ) current and emerging evidence on pharmacotherapies for obesity, including practical considerations in CKD, and (\n                    <jats:italic toggle=\"yes\">4<\/jats:italic>\n                    ) an integrated stepwise antiobesity management approach aligned with the cardiovascular\u2013kidney\u2013metabolic framework.\n                  <\/jats:p>","DOI":"10.2215\/cjn.0000001233","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:03:32Z","timestamp":1789142612000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Obesity and Cardiometabolic Health in Kidney Disease"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5582-3165","authenticated-orcid":false,"given":"Roy O.","family":"Mathew","sequence":"first","affiliation":[{"name":"Division of Nephrology, Loma Linda University, Loma Linda, California"},{"name":"Department of Medicine, Nephrology Section, VA Loma Linda, Loma Linda, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1619-2924","authenticated-orcid":false,"given":"Annie","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Loma Linda University, Loma Linda, California"},{"name":"Department of Medicine, Nephrology Section, VA Loma Linda, Loma Linda, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2571-3803","authenticated-orcid":false,"given":"Yoko","family":"Narasaki","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"},{"name":"Department of Medicine, Nephrology Section, VA Greater Los Angeles Healthcare System, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-3972","authenticated-orcid":false,"given":"Enrica","family":"Fung","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5869-7644","authenticated-orcid":false,"given":"Dianne S.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1977-8114","authenticated-orcid":false,"given":"Jennifer Y.","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7612-3352","authenticated-orcid":false,"given":"Matthew S.","family":"Durstenfeld","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla Y.","family":"Hsue","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"},{"name":"Department of Medicine, Cardiology Section, VA Greater Los Angeles Healthcare System, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9703-6469","authenticated-orcid":false,"given":"Connie M.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California"},{"name":"Department of Medicine, Nephrology Section, VA Greater Los Angeles Healthcare System, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"20","key":"B3-20261020","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1161\/CIR.0000000000001184","article-title":"Cardiovascular-kidney-metabolic health: a presidential advisory from the American heart association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation."},{"issue":"9","key":"B4-20261020","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.2215\/CJN.0000000744","article-title":"The cardiovascular-kidney-metabolic health framework: implications for nephrology","volume":"20","author":"Rangaswami","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"4","key":"B5-20261020","doi-asserted-by":"crossref","first-page":"471","DOI":"10.2215\/CJN.0000000690","article-title":"Do overweight status and obesity affect progression to ESKD in autosomal dominant polycystic kidney disease?","volume":"20","author":"Carriazo","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B6-20261020","doi-asserted-by":"crossref","first-page":"21","DOI":"10.7326\/0003-4819-144-1-200601030-00006","article-title":"Body mass index and risk for end-stage renal disease","volume":"144","author":"Hsu","year":"2006","journal-title":"Ann Intern Med."},{"issue":"9","key":"B7-20261020","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/S2213-8587(15)00128-X","article-title":"Association of age and BMI with kidney function and mortality: a cohort study","volume":"3","author":"Lu","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"4","key":"B8-20261020","doi-asserted-by":"crossref","first-page":"520","DOI":"10.2215\/CJN.0000000640","article-title":"Overweight status, obesity, and progression to ESKD in patients with autosomal dominant polycystic kidney disease","volume":"20","author":"Nowak","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"key":"B9-20261020","doi-asserted-by":"crossref","first-page":"20543581251380499","DOI":"10.1177\/20543581251380499","article-title":"Weight management experiences among people with CKD: a qualitative study","volume":"12","author":"Noori","year":"2025","journal-title":"Can J Kidney Health Dis."},{"issue":"3","key":"B10-20261020","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/MNH.0000000000000212","article-title":"The dual roles of obesity in chronic kidney disease: a review of the current literature","volume":"25","author":"Rhee","year":"2016","journal-title":"Curr Opin Nephrol Hypertens."},{"issue":"1","key":"B11-20261020","doi-asserted-by":"crossref","first-page":"E24","DOI":"10.1152\/ajpendo.00179.2022","article-title":"Obesity and chronic kidney disease","volume":"324","author":"Jiang","year":"2023","journal-title":"Am J Physiol Endocrinol Metab."},{"key":"B12-20261020","doi-asserted-by":"crossref","first-page":"2054358117698669","DOI":"10.1177\/2054358117698669","article-title":"World kidney day steering C. Obesity and kidney disease: hidden consequences of the epidemic","volume":"4","author":"Kovesdy","year":"2017","journal-title":"Can J Kidney Health Dis."},{"issue":"4","key":"B13-20261020","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1046\/j.1523-1755.2001.0590041498.x","article-title":"Obesity-related glomerulopathy: an emerging epidemic","volume":"59","author":"Kambham","year":"2001","journal-title":"Kidney Int."},{"issue":"8","key":"B14-20261020","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1038\/sj.ki.5002796","article-title":"Renal injury in the extremely obese patients with normal renal function","volume":"73","author":"Serra","year":"2008","journal-title":"Kidney Int."},{"issue":"8","key":"B15-20261020","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/nrneph.2016.75","article-title":"Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis","volume":"12","author":"D'Agati","year":"2016","journal-title":"Nat Rev Nephrol."},{"issue":"11","key":"B16-20261020","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1001\/2012.jama.11132","article-title":"Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults","volume":"308","author":"Neeland","year":"2012","journal-title":"JAMA."},{"issue":"5","key":"B17-20261020","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1172\/JCI81507","article-title":"Abdominal obesity: a marker of ectopic fat accumulation","volume":"125","author":"Smith","year":"2015","journal-title":"J Clin Invest."},{"issue":"1","key":"B18-20261020","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/j.ajkd.2015.05.023","article-title":"Waist circumference, body mass index, and ESRD in the REGARDS (reasons for geographic and racial differences in stroke) study","volume":"67","author":"Kramer","year":"2016","journal-title":"Am J Kidney Dis."},{"issue":"12","key":"B19-20261020","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1111\/j.1600-6143.2010.03330.x","article-title":"Body mass index, waist circumference and mortality in kidney transplant recipients","volume":"10","author":"Kovesdy","year":"2010","journal-title":"Am J Transplant."},{"key":"B20-20261020","doi-asserted-by":"crossref","first-page":"k5301","DOI":"10.1136\/bmj.k5301","article-title":"Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium","volume":"364","author":"Chang","year":"2019","journal-title":"BMJ."},{"issue":"1","key":"B21-20261020","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1186\/s12882-022-03026-9","article-title":"Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease","volume":"23","author":"Bullen","year":"2022","journal-title":"BMC Nephrol."},{"issue":"4","key":"B22-20261020","doi-asserted-by":"crossref","first-page":"503","DOI":"10.2215\/CJN.0000000000000403","article-title":"Central body fat distribution and kidney function after living kidney donation","volume":"19","author":"Westenberg","year":"2024","journal-title":"Clin J Am Soc Nephrol."},{"issue":"3","key":"B23-20261020","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1053\/j.ajkd.2024.02.014","article-title":"Visceral adiposity and progression of ADPKD: a cohort study of patients from the TEMPO 3:4 trial","volume":"84","author":"Nowak","year":"2024","journal-title":"Am J Kidney Dis."},{"issue":"5","key":"B24-20261020","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1161\/HYPERTENSIONAHA.110.157370","article-title":"Renal sinus fat and poor blood pressure control in middle-aged and elderly individuals at risk for cardiovascular events","volume":"56","author":"Chughtai","year":"2010","journal-title":"Hypertension."},{"issue":"2","key":"B25-20261020","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1161\/HYPERTENSIONAHA.116.07008","article-title":"Telmisartan ameliorates nephropathy in metabolic syndrome by reducing leptin release from perirenal adipose tissue","volume":"68","author":"Li","year":"2016","journal-title":"Hypertension."},{"issue":"1","key":"B26-20261020","first-page":"240","article-title":"Perirenal fat and chronic kidney disease: a systematic review and meta-analysis","volume":"50","author":"Kang","year":"2025","journal-title":"Kidney Blood Press Res."},{"issue":"3","key":"B27-20261020","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/ajcn\/81.3.543","article-title":"Survival advantages of obesity in dialysis patients","volume":"81","author":"Kalantar-Zadeh","year":"2005","journal-title":"Am J Clin Nutr."},{"issue":"1","key":"B28-20261020","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000437277","article-title":"Association of body mass index with clinical outcomes in non-dialysis-dependent chronic kidney disease: a systematic review and meta-analysis","volume":"6","author":"Ahmadi","year":"2015","journal-title":"Cardiorenal Med."},{"issue":"4S","key":"B29-20261020","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Stevens","year":"2024","journal-title":"Kidney Int"},{"issue":"2 suppl 1","key":"B30-20261020","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification","volume":"39","year":"2002","journal-title":"Am J Kidney Dis."},{"issue":"13","key":"B31-20261020","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1161\/CIRCULATIONAHA.117.029617","article-title":"Cardiovascular and metabolic heterogeneity of obesity: clinical challenges and implications for management","volume":"137","author":"Neeland","year":"2018","journal-title":"Circulation."},{"issue":"1","key":"B32-20261020","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/MNH.0000000000001131","article-title":"The obesity and lipid paradoxes in chronic kidney disease: mechanisms, interventions, and future directions","volume":"35","author":"Takahashi","year":"2026","journal-title":"Curr Opin Nephrol Hypertens."},{"issue":"6","key":"B33-20261020","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.2215\/CJN.02490508","article-title":"Association of visceral and subcutaneous adiposity with kidney function","volume":"3","author":"Young","year":"2008","journal-title":"Clin J Am Soc Nephrol."},{"issue":"5","key":"B34-20261020","doi-asserted-by":"crossref","first-page":"742","DOI":"10.2215\/CJN.0000000704","article-title":"Obesity and metabolic health in CKD","volume":"20","author":"Kovesdy","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"key":"B35-20261020","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.2147\/DMSO.S275898","article-title":"Obesity, insulin resistance, and type 2 diabetes: associations and therapeutic implications","volume":"13","author":"Wondmkun","year":"2020","journal-title":"Diabetes Metab Syndr Obes."},{"issue":"4","key":"B36-20261020","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1172\/JCI10842","article-title":"Obesity and insulin resistance","volume":"106","author":"Kahn","year":"2000","journal-title":"J Clin Invest."},{"issue":"3","key":"B37-20261020","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1093\/ckj\/sfv156","article-title":"Adipocytokines in renal transplant recipients","volume":"9","author":"Nagy","year":"2016","journal-title":"Clin Kidney J."},{"issue":"2","key":"B38-20261020","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1053\/j.ajkd.2015.02.325","article-title":"Association of adiponectin with body composition and mortality in hemodialysis patients","volume":"66","author":"Rhee","year":"2015","journal-title":"Am J Kidney Dis."},{"issue":"11","key":"B39-20261020","doi-asserted-by":"crossref","first-page":"525","DOI":"10.3390\/toxins17110525","article-title":"Leptin and adiponectin as uremic adipokines: associations with survival in a prospective hemodialysis cohort","volume":"17","author":"Bui","year":"2025","journal-title":"Toxins (Basel)."},{"issue":"11","key":"B40-20261020","doi-asserted-by":"crossref","first-page":"e13120","DOI":"10.1111\/obr.13120","article-title":"Usefulness of the Edmonton obesity staging system for stratifying the presence and severity of weight-related health problems in clinical and community settings: a rapid review of observational studies","volume":"21","author":"Atlantis","year":"2020","journal-title":"Obes Rev."},{"issue":"3 suppl 1","key":"B41-20261020","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/j.ajkd.2020.05.006","article-title":"KDOQI clinical Practice Guideline for nutrition in CKD: 2020 update","volume":"76","author":"Ikizler","year":"2020","journal-title":"Am J Kidney Dis."},{"issue":"8","key":"B42-20261020","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.2215\/CJN.0000000772","article-title":"Dietary protein intake recommendations for patients with non-dialysis-dependent CKD: what should healthcare providers do?","volume":"20","author":"Kovesdy","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"8","key":"B43-20261020","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.2215\/CJN.0000000896","article-title":"Kidney nutrition for value-based care models: the role of low protein diets and keto-analogue supplementation to delay dialysis","volume":"21","author":"Saville","year":"2026","journal-title":"Clin J Am Soc Nephrol."},{"issue":"3","key":"B44-20261020","doi-asserted-by":"crossref","first-page":"497","DOI":"10.2215\/CJN.0000000777","article-title":"Dietary protein intake in CKD: quantity and quality","volume":"21","author":"Fouque","year":"2026","journal-title":"Clin J Am Soc Nephrol."},{"issue":"9","key":"B45-20261020","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.2215\/CJN.0000000890","article-title":"Access to healthy foods and diet quality: implications for advancing equity in Kidney Health outcomes","volume":"21","author":"Hamdan","year":"2025","journal-title":"Clin J Am Soc Nephrol"},{"issue":"8","key":"B46-20261020","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.2215\/CJN.0000000706","article-title":"Plant-based diets across the spectrum of kidney disease","volume":"20","author":"Goraya","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B47-20261020","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/MNH.0000000000000761","article-title":"Medical nutrition therapy using plant-focused low-protein meal plans for management of chronic kidney disease in diabetes","volume":"31","author":"Kalantar-Zadeh","year":"2022","journal-title":"Curr Opin Nephrol Hypertens."},{"issue":"7","key":"B48-20261020","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.3390\/nu12071931","article-title":"Plant-dominant low-protein diet for conservative management of chronic kidney disease","volume":"12","author":"Kalantar-Zadeh","year":"2020","journal-title":"Nutrients."},{"issue":"1","key":"B49-20261020","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/s41387-024-00285-3","article-title":"Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial","volume":"14","author":"Podadera-Herreros","year":"2024","journal-title":"Nutr Diabetes."},{"issue":"10","key":"B50-20261020","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.2215\/CJN.0000000790","article-title":"A pilot clinical trial of a nutrition education program on quality of life in CKD","volume":"20","author":"Padial","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"6","key":"B51-20261020","doi-asserted-by":"crossref","first-page":"876","DOI":"10.2215\/CJN.0000000708","article-title":"Prescribing physical activity and exercise for people with CKD: a practical guide by the global renal exercise network","volume":"20","author":"Wilkinson","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B52-20261020","doi-asserted-by":"crossref","first-page":"144","DOI":"10.2215\/CJN.0000000784","article-title":"Physical activity and exercise for cardiometabolic health and fitness in CKD: an overview by exercise type","volume":"21","author":"Kistler","year":"2026","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B53-20261020","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2215\/CJN.18171120","article-title":"Dietary therapy for managing hyperphosphatemia","volume":"16","author":"Narasaki","year":"2020","journal-title":"Clin J Am Soc Nephrol."},{"issue":"6","key":"B54-20261020","doi-asserted-by":"crossref","first-page":"924","DOI":"10.2215\/CJN.0000000996","article-title":"Effectiveness of multicomponent interventions in slowing progression of CKD stages G3-G4: a systematic review and meta-analysis","volume":"21","author":"Ma","year":"2026","journal-title":"Clin J Am Soc Nephrol."},{"issue":"5","key":"B55-20261020","doi-asserted-by":"crossref","first-page":"739","DOI":"10.2215\/CJN.0000000703","article-title":"Introduction to the lifestyle medicine and kidney health series","volume":"20","author":"Boaz","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"10","key":"B56-20261020","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.2215\/CJN.0000000728","article-title":"Sleep-related disorders in patients with CKD and kidney transplant recipients","volume":"20","author":"Vendeville","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"12","key":"B57-20261020","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.2215\/CJN.0000000829","article-title":"Contemplative practices as a form of stress management for patients with kidney disease","volume":"20","author":"Bruce","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"5","key":"B58-20261020","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1161\/CIR.0000000000001078","article-title":"Life's essential 8: updating and enhancing the American heart association's construct of cardiovascular health: a presidential advisory from the American heart association","volume":"146","author":"Lloyd-Jones","year":"2022","journal-title":"Circulation."},{"issue":"24","key":"B59-20261020","doi-asserted-by":"crossref","first-page":"e030564","DOI":"10.1161\/JAHA.123.030564","article-title":"Associations between life's essential 8 and chronic kidney disease","volume":"12","author":"Ren","year":"2023","journal-title":"J Am Heart Assoc."},{"issue":"4","key":"B60-20261020","doi-asserted-by":"crossref","first-page":"502","DOI":"10.2215\/CJN.0000000656","article-title":"Life's essential 8, cardiovascular health, and CKD progression among hispanic\/latino adults: the Hispanic community health study\/study of latinos study","volume":"20","author":"Chakrabarti","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B61-20261020","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1038\/s41392-024-01931-z","article-title":"Glucagon-like peptide-1 receptor: mechanisms and advances in therapy","volume":"9","author":"Zheng","year":"2024","journal-title":"Signal Transduct Target Ther."},{"issue":"10","key":"B62-20261020","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1038\/nrneph.2017.123","article-title":"GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes","volume":"13","author":"Muskiet","year":"2017","journal-title":"Nat Rev Nephrol."},{"issue":"1","key":"B63-20261020","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12933-022-01604-7","article-title":"Tirzepatide, a dual GIP\/GLP-1 receptor co-agonist for the treatment of type 2 diabetes with unmatched effectiveness regrading glycaemic control and body weight reduction","volume":"21","author":"Nauck","year":"2022","journal-title":"Cardiovasc Diabetol."},{"issue":"4","key":"B64-20261020","doi-asserted-by":"crossref","first-page":"579","DOI":"10.2337\/cd24-0062","article-title":"Retatrutide","volume":"42","author":"Ramsbacher","year":"2024","journal-title":"Clin Diabetes."},{"key":"B65-20261020","doi-asserted-by":"crossref","first-page":"100502","DOI":"10.1016\/j.ajpc.2023.100502","article-title":"Glucagon-like peptide-1 receptor agonists in diabetic kidney disease: a review of their kidney and heart protection","volume":"14","author":"Michos","year":"2023","journal-title":"Am J Prev Cardiol."},{"issue":"4","key":"B66-20261020","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and cardiovascular outcomes in type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med."},{"issue":"19","key":"B67-20261020","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med."},{"issue":"10193","key":"B68-20261020","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","article-title":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet."},{"issue":"3","key":"B69-20261020","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S2213-8587(23)00388-1","article-title":"Efficacy and safety of once weekly semaglutide 2.4 mg for weight management in a predominantly east Asian population with overweight or obesity (STEP 7): a double-blind, multicentre, randomised controlled trial","volume":"12","author":"Mu","year":"2024","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"3","key":"B70-20261020","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S2213-8587(22)00008-0","article-title":"Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial","volume":"10","author":"Kadowaki","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"10","key":"B71-20261020","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1038\/s41591-022-02026-4","article-title":"Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial","volume":"28","author":"Garvey","year":"2022","journal-title":"Nat Med."},{"issue":"2","key":"B72-20261020","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1001\/jama.2021.23619","article-title":"Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clinical trial","volume":"327","author":"Rubino","year":"2022","journal-title":"JAMA."},{"issue":"14","key":"B73-20261020","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1001\/jama.2021.3224","article-title":"Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial","volume":"325","author":"Rubino","year":"2021","journal-title":"JAMA."},{"issue":"14","key":"B74-20261020","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1001\/jama.2021.1831","article-title":"Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial","volume":"325","author":"Wadden","year":"2021","journal-title":"JAMA."},{"issue":"10278","key":"B75-20261020","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0140-6736(21)00213-0","article-title":"Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial","volume":"397","author":"Davies","year":"2021","journal-title":"Lancet."},{"issue":"11","key":"B76-20261020","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-weekly semaglutide in adults with overweight or obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N Engl J Med."},{"issue":"24","key":"B77-20261020","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and cardiovascular outcomes in obesity without diabetes","volume":"389","author":"Lincoff","year":"2023","journal-title":"N Engl J Med."},{"issue":"2","key":"B78-20261020","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med."},{"issue":"1","key":"B79-20261020","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S2213-8587(24)00271-7","article-title":"Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trials","volume":"13","author":"Badve","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"2","key":"B80-20261020","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2215\/CJN.0000000584","article-title":"The impact of glucagon-like Peptide-1 receptor agonists on kidney outcomes: a meta-analysis of randomized placebo-controlled trials","volume":"20","author":"Mendonca","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"6","key":"B81-20261020","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1001\/jama.2022.0078","article-title":"Effect of subcutaneous tirzepatide vs placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes: the SURPASS-5 randomized clinical trial","volume":"327","author":"Dahl","year":"2022","journal-title":"JAMA."},{"issue":"10313","key":"B82-20261020","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/S0140-6736(21)02188-7","article-title":"Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial","volume":"398","author":"Del Prato","year":"2021","journal-title":"Lancet."},{"issue":"10300","key":"B83-20261020","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0140-6736(21)01443-4","article-title":"Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial","volume":"398","author":"Ludvik","year":"2021","journal-title":"Lancet."},{"issue":"6","key":"B84-20261020","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa2107519","article-title":"Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes","volume":"385","author":"Frias","year":"2021","journal-title":"N Engl J Med."},{"issue":"10295","key":"B85-20261020","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0140-6736(21)01324-6","article-title":"Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial","volume":"398","author":"Rosenstock","year":"2021","journal-title":"Lancet."},{"issue":"1","key":"B86-20261020","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1056\/NEJMoa2416394","article-title":"Tirzepatide as compared with semaglutide for the treatment of obesity","volume":"393","author":"Aronne","year":"2025","journal-title":"N Engl J Med."},{"issue":"11","key":"B87-20261020","doi-asserted-by":"crossref","first-page":"2909","DOI":"10.1038\/s41591-023-02597-w","article-title":"Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial","volume":"29","author":"Wadden","year":"2023","journal-title":"Nat Med."},{"issue":"10402","key":"B88-20261020","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0140-6736(23)01200-X","article-title":"Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial","volume":"402","author":"Garvey","year":"2023","journal-title":"Lancet."},{"issue":"3","key":"B89-20261020","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2206038","article-title":"Tirzepatide once weekly for the treatment of obesity","volume":"387","author":"Jastreboff","year":"2022","journal-title":"N Engl J Med."},{"issue":"3","key":"B90-20261020","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1111\/dom.15410","article-title":"Effect of tirzepatide on albuminuria levels and renal function in patients with type 2 diabetes mellitus: a systematic review and multilevel meta-analysis","volume":"26","author":"Karakasis","year":"2024","journal-title":"Diabetes Obes Metab."},{"issue":"1","key":"B91-20261020","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/dom.70209","article-title":"Retatrutide for the treatment of obesity, obstructive sleep apnea and knee osteoarthritis: rationale and design of the TRIUMPH registrational clinical trials","volume":"28","author":"Giblin","year":"2026","journal-title":"Diabetes Obes Metab."},{"issue":"6","key":"B92-20261020","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1056\/NEJMoa2301972","article-title":"Triple-hormone-receptor agonist retatrutide for obesity - a phase 2 trial","volume":"389","author":"Jastreboff","year":"2023","journal-title":"N Engl J Med."},{"issue":"6","key":"B93-20261020","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/j.ekir.2025.03.049","article-title":"The effect of retatrutide on kidney parameters in participants with type 2 diabetes mellitus and\/or obesity","volume":"10","author":"Heerspink","year":"2025","journal-title":"Kidney Int Rep."},{"issue":"suppl 1","key":"B94-20261020","first-page":"S246","article-title":"Chronic kidney disease and risk management: standards of care in Diabetes-2026","volume":"49","year":"2026","journal-title":"Diabetes Care"},{"issue":"4","key":"B95-20261020","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2020.06.019","article-title":"KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease","volume":"98","author":"de Boer","year":"2020","journal-title":"Kidney Int"},{"issue":"1","key":"B96-20261020","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/oby.23331","article-title":"SGLT inhibitors on weight and body mass: a meta-analysis of 116 randomized-controlled trials","volume":"30","author":"Cheong","year":"2022","journal-title":"Obesity (Silver Spring)."},{"issue":"3","key":"B97-20261020","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s40265-019-1057-0","article-title":"Emerging role of SGLT-2 inhibitors for the treatment of obesity","volume":"79","author":"Pereira","year":"2019","journal-title":"Drugs."},{"issue":"3-4","key":"B98-20261020","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1900\/RDS.2014.11.202","article-title":"Adverse effects of GLP-1 receptor agonists","volume":"11","author":"Filippatos","year":"2014","journal-title":"Rev Diabet Stud."},{"issue":"9","key":"B99-20261020","doi-asserted-by":"crossref","first-page":"sfae250","DOI":"10.1093\/ckj\/sfae250","article-title":"Semaglutide-associated kidney injury","volume":"17","author":"Begum","year":"2024","journal-title":"Clin Kidney J."},{"key":"B100-20261020","first-page":"100814","article-title":"Safety of SGLT2 inhibitors, DPP-4 inhibitors, and GLP-1 receptor agonists in US veterans with and without chronic kidney disease: a population-based study","volume":"36","author":"Narasaki","year":"2024","journal-title":"Lancet Reg Health Am."},{"issue":"8","key":"B101-20261020","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.2215\/CJN.0000000750","article-title":"GLP-1 receptor agonist outcomes, safety, and body mass index change in a national cohort of patients on dialysis","volume":"20","author":"Orandi","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"2","key":"B102-20261020","doi-asserted-by":"crossref","first-page":"206","DOI":"10.2337\/dc15-1025","article-title":"Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: an investigator-initiated, placebo-controlled, double-blind, parallel-group, randomized trial","volume":"39","author":"Idorn","year":"2016","journal-title":"Diabetes Care."},{"issue":"6","key":"B103-20261020","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1038\/ki.2013.147","article-title":"Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism","volume":"84","author":"Ikizler","year":"2013","journal-title":"Kidney Int."},{"issue":"6","key":"B104-20261020","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1053\/j.jrn.2018.08.006","article-title":"Global prevalence of protein-energy wasting in kidney disease: a meta-analysis of contemporary observational studies from the international society of renal nutrition and metabolism","volume":"28","author":"Carrero","year":"2018","journal-title":"J Ren Nutr."},{"issue":"4","key":"B105-20261020","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1002\/jcsm.13260","article-title":"Kidney function in cachexia and sarcopenia: facts and numbers","volume":"14","author":"Okamura","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle."},{"issue":"5","key":"B107-20261020","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S2213-8587(24)00371-1","article-title":"GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort study","volume":"13","author":"Orandi","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"2","key":"B108-20261020","doi-asserted-by":"crossref","first-page":"sfae018","DOI":"10.1093\/ckj\/sfae018","article-title":"Safety and efficacy of glucagon-like peptide-1 receptor agonists among kidney transplant recipients: a systematic review and meta-analysis","volume":"17","author":"Krisanapan","year":"2024","journal-title":"Clin Kidney J."},{"issue":"9","key":"B109-20261020","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jama.2014.10706","article-title":"Long-term follow-up after bariatric surgery: a systematic review","volume":"312","author":"Puzziferri","year":"2014","journal-title":"JAMA."},{"issue":"10","key":"B110-20261020","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.2215\/CJN.02250409","article-title":"Weight loss interventions in chronic kidney disease: a systematic review and meta-analysis","volume":"4","author":"Navaneethan","year":"2009","journal-title":"Clin J Am Soc Nephrol."},{"issue":"suppl 4","key":"B111-20261020","doi-asserted-by":"crossref","first-page":"iv82","DOI":"10.1093\/ndt\/gft302","article-title":"Effects of weight loss on renal function in obese CKD patients: a systematic review","volume":"28","author":"Bolignano","year":"2013","journal-title":"Nephrol Dial Transplant."},{"issue":"1","key":"B112-20261020","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1681\/ASN.0000000797","article-title":"Measurement, estimation, and correlates of the GFR before and after bariatric surgery","volume":"37","author":"Friedman","year":"2026","journal-title":"J Am Soc Nephrol."},{"issue":"8","key":"B113-20261020","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1001\/jama.2024.0318","article-title":"Long-term outcomes of medical management vs bariatric surgery in type 2 diabetes","volume":"331","author":"Courcoulas","year":"2024","journal-title":"JAMA."},{"issue":"4","key":"B114-20261020","doi-asserted-by":"crossref","first-page":"496","DOI":"10.2337\/db22-0696","article-title":"Association between obesity and chronic kidney disease: multivariable mendelian randomization analysis and observational data from a bariatric surgery cohort","volume":"72","author":"Nguyen","year":"2023","journal-title":"Diabetes."},{"issue":"7","key":"B115-20261020","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1001\/jama.2015.9676","article-title":"Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial","volume":"314","author":"Davies","year":"2015","journal-title":"JAMA."},{"issue":"10192","key":"B116-20261020","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0140-6736(19)31271-1","article-title":"Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial","volume":"394","author":"Pratley","year":"2019","journal-title":"Lancet."},{"issue":"12","key":"B117-20261020","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1056\/NEJMoa2306963","article-title":"Semaglutide in patients with heart failure with preserved ejection fraction and obesity","volume":"389","author":"Kosiborod","year":"2023","journal-title":"N Engl J Med."},{"issue":"20","key":"B118-20261020","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1056\/NEJMoa2501006","article-title":"Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes","volume":"392","author":"McGuire","year":"2025","journal-title":"N Engl J Med."}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T20:00:33Z","timestamp":1792526433000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001233"}},"subtitle":["Implications for Kidney Health, Risk Stratification, and Management"],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":115,"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001233","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]}}}