Case of obesity-related glomerulopathy treated by pronounced weight loss by diet and exercise

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We experienced a 46-year-old man with rapidly declining renal function over the past 5 years. By strict diet and exercise regimen, he reduced his body mass index (BMI) from 35.1 to 24.8 over 15 months, which prevented the progression of renal dysfunction for the next 10 years. Kidney biopsy showed focal segmental glomerulosclerosis (FSGS) corresponding to obesity-related glomerulopathy . Besides suppressing the progression of renal function decline, resolution of the significant obesity reduced proteinuria and improved blood pressure control. We concluded that obesity itself caused FSGS, probably via hyperfiltration , which caused refractory hypertension and triggered proteinuria, resulting in renal function decline.