• A particular receptor in kidney cells plays an important role in obesity-induced fat accumulation, dysfunction, injury, inflammation, and scarring in the kidney.
  • The receptor acts through a certain signaling pathway.
  • Targeting this receptor or the signaling pathway may help protect the kidneys of individuals who develop obesity.

Structural and functional changes in the kidneys develop early in the course of obesity.

Newswise — Washington, DC (August 31, 2017) — A new study provides insights on the mechanisms behind the development of kidney damage due to obesity. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), point to a potential target for protecting the kidney health of individuals with obesity.

Obesity can cause structural and functional changes in the kidneys, which may help explain why individuals with obesity face an elevated risk of chronic kidney disease and its progression to kidney failure. Although multiple metabolic factors have been proposed to contribute to obesity-induced kidney problems, the underlying mechanisms are not completely understood.

To investigate, a team led by Joseph Tam, DMD, PhD and PhD student Shiran Udi, MSc (Institute for Drug Research, The Hebrew University of Jerusalem, in Israel) examined the kidney cells that are responsible for the reabsorption of nutrients, while allowing other substances of no nutritional value to be excreted in the urine. These renal proximal tubular cells (RPTCs) are especially sensitive to the accumulation of fat, or lipids, an effect called lipotoxicity. The researchers examined the potential role of endocannabinoids, lipid molecules that act on a cellular receptor (CB1R), in RPTC lipotoxicity. 

Mice that lacked expression of the receptor in RPTCs experienced significantly less obesity-induced lipid accumulation in the kidney as well as less kidney dysfunction, injury, inflammation, and scarring. Moreover, the study revealed the molecular signaling pathway involved in mediating the CB1R-induced kidney injury and lipotoxicity in RPTCs. Specifically, these deleterious effects associated with decreased activation of liver kinase B1 and the energy sensor AMP-activated protein kinase, as well as reduced fatty acid β-oxidation.

“This work provides a novel approach to slow the development of renal injury through chronic blockade of peripheral CB1Rs,” said Dr. Tam. “And, it also supports strategies aimed at reducing the activity of the endocannabinoid system, specifically in the kidney, to attenuate the development of RPTC dysfunction in obesity.”

Study co-authors include Liad Hinden, PhD, Brian Earley, MSc, Adi Drori, PhD, Noa Reuveni, Rivka Hadar, MSc, Resat Cinar, PhD, and Alina Nemirovski, PhD. 

Disclosures: The work was supported by a German-Israeli Foundation grant (#I-2345-201.2/2014), and an ERC-2015-StG grant (#676841) to Dr. Joseph Tam. The authors reported no other financial disclosures.

The article, entitled “Proximal Tubular Cannabinoid-1 Receptor Regulates Obesity-Induced CKD,” will appear online at http://jasn.asnjournals.org/ on August 31, 2017, doi: 10.1681/ASN.2016101085.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 17,000 members representing 112 countries. For more information, please visit www.asn-online.org or contact the society at 202-640-4660.

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Journal of the American Society of Nephrology (JASN) 10.1681/ASN.2016101085