Aim of the work: is to investigate the relation between serum fetuin-A level and renal impairment induced by obesity in comparison with that induced by gentamicin in rats and to determine the effect of fenofibrate treatment. Materials and Methods: 58 male rats were divided into four groups Control group: 15 rats were fed standard chow diet. Obese group 13 rats were fed a High fat diet (HFD). Then, albumin/ creatinine ratio (ACR) was done and according to the result of this test, this group was diagnosed as obese group with renal impairment. Fenofibrate treated obese group: 15 rats were fed a HFD along with fenofibrate. Gentamicin induced renal impairment group: 15 rats were fed stander chow diet. In the last eight days they were injected intraperitoneally with gentamicin. Body mass index (BMI) was measured. Urine was collected albumin, creatinine were measured in urine, blood was collected and serum urea, creatinine, fetuin-A, adiponectin, tumor necrosis alpha (TNF-α), malondialdehyde (MDA), reduced glutathione, fasting glucose, insulin, HOMA IR, lipid profile, calcium, phosphorus and solubility product were measured. Results: Fetuin ?A was significantly increased in obese group with renal impairment. This group also showed significant increase in ACR, serum urea, creatinine and phosphorus. Also, there was positive correlation between serum fetuin-A and BMI, ACR with a negative correlation between it and adiponectin. Also, it showed significant decrease in adiponectin, reduced glutathione and HDL and significant increase in BMI, TNF-α, MDA, Insulin, HOMA IR, triglyceride, LDL. However, fenofiberates intervention was associated with significant correction of all these parameters. In gentamicin induced renal impairment group, there was only significant increase in ACR, serum urea, creatinine, TNF-α, MDA and significant decrease in reduced glutathione. Fetuin-A shows no significant change when compared to control group. Conclusion: Fetuin-A may be associated with obesity-related renal impairment. So, more researches should done to investigate whether reduction of serum fetuin-A may hamper the development and progression of obesity-related complications or not. Also fenofibrate is found to be protective to renal impairment with obesity.