Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Obesity-related glomerulopathy (ORG) is an increasingly recognized secondary form of focal segmental glomerulosclerosis (FSGS) that occurs as an adaptive glomerular response to obesity and metabolic stress. Because of overlapping features with other forms of secondary or primary FSGS, establishing standard diagnostic criteria is essential. We report a multicentre case series of nine biopsy-proven ORG cases evaluated using the recently proposed diagnostic framework, emphasizing clinicopathological correlations and the role of supportive imaging and biomarkers.
Nine adult patients diagnosed with ORG between 2018 and 2023 across multiple tertiary nephrology centres were retrospectively analysed. Inclusion required renal biopsy showing glomerulomegaly ± perihilar FSGS and absence of immune deposits; cases with diabetic nodular sclerosis or other secondary causes were excluded. Clinical data included BMI, blood pressure, proteinuria, renal function, metabolic indices, and imaging findings. The diagnostic framework (Table 1) was applied*; all patients fulfilled all essential criteria and at least two supportive criteria.
Table 1. Proposed Diagnostic Framework for Obesity-Related Glomerulopathy (ORG)
Component
Criteria
Essential Criteria
1. BMI ≥ 30 kg/m² (≥ 25 kg/m² for Asian populations)
2. Subnephrotic or nephrotic-range proteinuria without full nephrotic syndrome
3. Histopathology showing glomerulomegaly ± perihilar variant of FSGS
4. Absence of immune-complex deposition on IF/EM with partial foot-process effacement
5. Exclusion of other causes of secondary FSGS (e.g., viral infections, drugs, reduced renal mass)
Supportive Criteria
1. Imaging: enlarged kidneys with increased PUFT/RSF
2. Elevated leptin/reduced adiponectin
3. Increased suPAR
4. Elevated KIM-1, cystatin C, NAG, NGAL
5. Mild–moderate hypertension
6. Insulin resistance
7. Absence of diabetic retinopathy or typical diabetic lesions (in diabetics).
* Sharma S, Sharma A, Kapoor N, Sharma N, Saravanan P, Kalra S. Obesity-related glomerulopathy: a lesser known complication of obesity. Curr Opin Endocrinol Diabetes Obes. 2025 Sep 8.
The cohort (n = 9) included 6 males and 3 females, with a mean age of 44.0 ± 9.9 years and mean BMI 35.4 ± 2.2 kg/m². Hypertension and diabetes were present in 7 (77.8 %) and 4 (44.4 %) cases respectively. Median proteinuria was 1.5 g/day (IQR 0.9–2.3), and mean eGFR 90 ± 20 mL/min/1.73 m². PUFT/RSF increase was observed in 7 (77.8 %), and insulin resistance in 6 (66.7 %) patients. EM was available in 4 cases and revealed partial foot-process effacement (mean 42.5 ± 6.4 %) without immune deposits. Table 2 depicts the clinical and laboratory features of the cases included. Histopathological features are summarized in Table 3. All biopsies revealed glomerulomegaly; seven (77.8 %) showed perihilar FSGS, and all EM samples exhibited partial (≤50 %) podocyte effacement without immune deposits. Mild interstitial fibrosis/tubular atrophy (≤20 %) occurred in 8 cases (88.9 %). BMI correlated positively with proteinuria (r = 0.63, p = 0.03) and inversely with eGFR (r = –0.46, p = 0.05). PUFT/RSF positivity correlated with the degree of foot-process effacement (r = 0.57, p = 0.05). Age, gender, and diabetes status showed no significant association with proteinuria or histologic severity.
Table 2. Clinical and Laboratory Features of Nine ORG Cases
Parameter
Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7
Case 8
Case 9
Age (yrs)
28
33
37
40
45
48
52
54
59
Gender
Male
Female
BMI (kg/m²)
31.8
36.2
32.4
34.6
35.8
38.1
33.5
37.0
34.1
Diabetes
–
+
Hypertension
Proteinuria (g/day)
1.1
1.8
0.7
2.3
1.5
0.9
2.8
0.6
1.4
eGFR (mL/min/1.73 m²)
105
92
118
74
80
96
68
102
85
PUFT/RSF Imaging
Insulin Resistance
EM Performed
Yes
Foot Process Effacement (%)
35
50
Table 3. Diagnostic and Histopathological Correlations
Feature
Frequency (n = 9)
% of Cases
Glomerulomegaly (≥ 200 µm)
9
100
Perihilar FSGS pattern
7
77.8
Segmental sclerosis > 20 %
6
66.7
IFTA ≤ 20 %
8
88.9
Arteriolar hyalinosis
5
55.6
No immune deposits
Partial FPE ≤ 50 % (on EM)
4/4
Correlation of FPE with proteinuria
r = 0.58, p = 0.04
—
ORG is predominantly reported in middle-aged, obese individuals presenting with mild-to-moderate proteinuria and preserved renal function. Glomerulomegaly and perihilar FSGS were universal histologic findings. Strong correlations were observed between BMI, perirenal fat accumulation, and proteinuria intensity, supporting the hemodynamic and metabolic mechanisms underlying ORG. Application of the proposed diagnostic framework reliably identified all cases, even where EM was unavailable, validating its practical diagnostic utility. Prospective studies with biomarker and imaging quantification are warranted to refine specificity and establish prognostic value in diverse populations.
