Obesity has been increasing worldwide over recent decades. According to the World Health Organization, approximately 650 million adults are living with obesity, accounting for 13% of the global population. In Vietnam, the prevalence of obesity in adults has increased more than six-fold from 1975 to 2015. The rising rate of obesity contributes to the growing burden of diseases, including kidney disease. Increases in average body weight and body mass index (BMI) are associated with a higher incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Obesity not only accelerates the progression of pre-existing kidney diseases but is also an independent risk factor for kidney injury. Its effects on the kidneys occur through multiple mechanisms, influencing both renal structure and function. These mechanisms include: obesityrelated glomerulopathy, imbalance of adipokines, insulin resistance, lipotoxicity, overactivation of the sympathetic nervous system and the renin–angiotensin–aldosterone system (RAAS), local adipose tissue RAAS activation, alterations in gut microbiota, and chronic inflammation. Clinically, obesity-related renal effects manifest as albuminuria/proteinuria, nephrotic-range proteinuria, CKD progression, ESKD, nephrolithiasis, renal cell carcinoma, and renal steatosis. Therefore, obesity should be recognized and managed as a disease, with timely diagnosis to prevent systemic and renal complications. BMI is a simple and practical indicator for diagnosing obesity in clinical practice; however, its accuracy may be limited in patients with CKD. Interventions targeting obesity have demonstrated improvements in clinical outcomes. Current obesity management strategies include lifestyle modification, pharmacotherapy, and bariatric surgery. Nevertheless, treating obesity in individuals with chronic kidney disease remains a major clinical challenge.