With the recent rise in the prevalence of obesity worldwide, obesity-related albuminuria is now being recognized as a critical risk factor for cardiovascular disease. However, there is an urgent need for a better understanding of this association. Recent clinical studies suggest that the adipocyte hormone adiponectin may play a key role in the development of obesity-related albuminuria. Moreover, studies with the adiponectin knockout mouse indicate that adiponectin can regulate podocyte function and thus contribute to the initial development of albuminuria. Future studies examining renal adipocyte cell biology are needed to develop preventive and therapeutic strategies for combatting the complications of obesity.