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Renal biopsy findings in patients with extreme obesity: more heterogeneous than you think. The number of obese and morbidly obese patients is increasing and so is the burden of renal disease in these patients. In a large series of biopsies from the morbidly obese patient population, Choung et al. show that there is heterogeneity in the renal disease affecting this population. It is imperative that the underlying renal disease in obese patients be correctly diagnosed for optimal management.