INS and obesity due to melanocortin 4 receptor deficiency: Obesity may contribute to the development of CKD through pathways related to insulin resistance that can cause renal injury, such as activation of the renin-angiotensin-aldosterone system, activation of insulin/insulin-like growth factor-1 signaling pathways, oxidative stress, suppression of peroxisome proliferatoractivated receptor gamma, inflammation-related tissue damage, nephrosclerosis, and activation of the renal sympathetic system [4, 27].