Obesity in relation to cardiorenal function

Obesity is a growing pandemic with serious impact on renal and cardiovascular function. Complex associations between obesity and cardiorenal function involving different pathological pathways, also referred to as obesity-related cardiorenal dysfunction, have been described based on preclinical and clinical studies. However, the exact relationship between obesity and the development of chronic kidney disease and cardiovascular disease remains unclear. The interaction of cardiac and renal dysfunction in obesity has been investigated in a wide range of species, from rodent to swine models. The availability of such animal models allows us to further explore the metabolic mechanisms of cardiorenal syndrome, and more importantly, potential therapeutic strategies. This chapter provides an overview of obese animal models exhibiting cardiorenal syndrome and discusses the Zucker rat and substrains as proposed models of the metabolic cardiorenal syndrome in more detail. In obesity, large amounts of energy in the form of triglycerides are stored in different fat compartments; initially in adipose tissue, and in excess in nonadipose tissues (ectopic lipid deposition). Increasing number of studies suggest that ectopic lipid deposition, reflecting diminished adipose tissue expandability, is a superior biomarker of obesity-related end organ dysfunction than traditional measures of obesity such as BMI and waist circumference. Recent studies have explored the interplay of fat compartments and ectopic lipid deposition on renal and cardiac function in both animal models and humans, evaluating dietary effects and the effects of glycemic control using novel antihyperglycemic medications. Furthermore, this chapter discusses the possibility of a personalized medicine-based approach in the management of obesity-related chronic kidney disease and cardiovascular disease via the use of in-vivo metabolic imaging.