Chronic kidney disease (CKD) is associated with end
stage renal disease, as well as cardiovascular morbidity
and mortality. The prevalence of CKD has rapidly
increased with obesity epidemic. Cross sectional and
cohort studies showed that an increased body mass index
was significantly associated with the development of CKD
and deterioration of renal function. Complex mechanistic
linkage between obesity and CKD could be explained
through renal oppression by fat tissue, increased
angiotensinogen production, activation of sympathetic
activity, insulin resistance, and increased inflammatory
cytokines. Serum levels of adipokine (leptin, adiponectin)
are markedly elevated in chronic kidney disease. High
levels of serum adipokine attributed to cardiovascular
disease and early death in CKD through their effects on
insulin signaling, endothelial dysfunction, and increase of
inflammatory cytokine. Patients with end-stage renal
disease (ESDR) under hemodialysis showed that an
increased body mass index (BMI) was associated with
better survival. The possible causes and mechanisms of
reverse epidemiology was not fully understood, but
concurrent chronic disease, wasting, inflammation, insulin
resistance and vascular injuries might be related. Obesity
management and prevention is important, because it is a
modifiable risk factor that is closely related with CKD as
well as CKD associated cardiovascular risk factors.

Keywords: Obesity, Chronic kidney disease, Body mass
index, Abdominal obesity, Inflammation