**3. Treatment of Obesity and Renal Damage**

Losing weight is key in limiting the impact that obesity produces on the kidneys by reducing albuminuria/proteinuria, declining rate of eGFR deterioration, delaying the development of CKD and ESKD and improving the outcome of a renal transplant. The resulting effects due to weight reduction are multiple. Aside from a reduction in BP as well as control of other CV risk factors, reduction of leptin, glomerular hyperfiltration, RAAS activity, inflammation, and oxidative stress seem to be the most relevant. Considering the characteristic hyperfiltration hemodynamic profile and the relevance of hyperfiltrationmediated conditions in obesity-induced renal damage, reduction in filtration fraction is the main mechanism that provides a beneficial impact to the subject who has lost weight. In addition, a reduction in the activity of the RAAS has also been observed [88]. Weight reduction may also contribute to appropriate control of cardiometabolic risk factors such as hypertension, metabolic syndrome, diabetes, and dyslipidemia which may be protective not only in renal damage but also cardiovascular disease [89].
