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Obesity is recently acknowledged as an important independent risk factor for kidney disease, in which epidemiological evidence played a crucial role. This risk is probably explained by intracellular lipid accumulation in the kidney. Lifestyle factors such as physical activity and diet play a role in the development of kidney disease in several stages: development of obesity and the metabolic syndrome, occurrence of obesity-related glomerulopathy, improvement of hemodialysis patients, and prevention of graft dysfunction and graft loss after renal transplantation. After the recent success of lifestyle intervention to prevent diabetes, further research is needed to show the effects of lifestyle changes to prevent and reduce obesity-related morbidity, including chronic kidney disease.