There are several common biological states directly linking obesity to kidney dysfunction independent of metabolic risk factors, including hemodynamic changes, oxidative stress, hormonal effects, and activation of the renin-angiotensin-aldosterone system, which are common in overweight and obesity states and could changes renal hemodynamic via activation of the renal sympathetic system (37,47-49). The gene discussed is REN; the disease is obesity due to melanocortin 4 receptor deficiency.