*2.9. Other Obesity-Associated Conditions and Renal Damage*

Two frequent complications of obesity seem to further increase the risk of renal damage. First is sleep-apnea and nocturnal hypoxemia, which have been associated with loss of kidney function through activation of the renin-angiotensin system [86]. Second is non-alcoholic fatty liver disease (NAFLD). In a meta-analysis of 33 studies, NAFLD, non-alcoholic steatohepatitis, and advanced fibrosis were associated with an increased risk of prevalence and incidence of CKD, with a graded risk from the presence to the severity of NAFLD [87].
