The KDIGO Controversies Conference on the Relationship Between Obesity and CKD: Pathophysiology, Prognosis, and Management took place in Prague, Czechia, from October 10 to 13, 2024. Drs. Susan Furth (Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, United States) and Peter Rossing (Steno Diabetes Center Copenhagen and University of Copenhagen, Denmark) co-chaired this conference.

Obesity is increasing in both adults and children, with an expected 1.5 billion people living with obesity by 2035. Chronic kidney disease (CKD) is also on the rise, affecting over 800 million people globally. Obesity is a driver for diabetes and hypertension, the two leading causes of CKD in most countries, and obesity may also directly induce CKD. Treatment with an optimized diet and exercise is preferred but often difficult to sustain. While recent trials have shown positive outcomes in metabolic surgery or pharmacological interventions with substantial weight reductions maintained, questions remain about the relationship between obesity and CKD, how their coexistence relates to diagnosis, and optimal strategies for management, especially in people with CKD.

This conference involved topical plenary session presentations followed by focused discussion groups that reported back to the full group for consensus building. This highly interactive conference included key thought leaders and relevant stakeholders, including patients, experts in nephrology (adult and pediatric), endocrinology, cardiology, surgery, and other related disciplines (nutrition, epidemiology, ethics, nursing, social work, etc.) who comprehensively reviewed the literature and current state of understanding in this area and addressed clinical issues as outlined in the Scope of Work.

The conference manuscript is currently being prepared.