Obesity-Related Renal Injury in Childhood

Abstract

A significant increase in the prevalence of end-stage renal disease (ESRD) has been reported over the last three decades, paralleling the increasing prevalence of obesity and insulin resistance, also in the pediatric population. Overweight, obesity and the metabolic syndrome, which frequently coexist, contribute substantially to cardiovascular disease and ESRD. A higher body mass index, the presence of type 2 diabetes, hypertension and, of particular importance, reduced insulin sensitivity (IS), have recently emerged as strong independent risk factors for chronic kidney disease and ESRD. Of particular concern, the long-term cardiovascular impact of obesity, although deferred to adult life, has its origins in childhood. Clustering of cardiovascular risk factors is seen in children and adolescents with the highest degree of reduced IS, suggesting that adult consequences of obesity on target organs, including the kidney, are more likely to develop in these young people. This review will discuss the association between obesity and the risk of kidney disease, focusing on the way in which obesity and its metabolic complications may lead to renal involvement and injury, with particular regard to childhood. It is beyond the scope of this article to examine kidney disease as a component of syndromes that result in obesity in childhood.

Hypertension in pediatric patients with chronic kidney disease: management challenges

“…51,[60][61][62][63] Obesity, or increased BMI, can now be considered as a risk factor not just for cardiovascular disease and diabetes, but also for CKD. 51,64 The increase in CKD in those who are obese is thought to be in part due to increased metabolic demands which, in turn, lead to a compensatory glomerular hyperfiltration injury in the kidney.…”

Childhood obesity, renal injury and future disease risk

“…As hyperinsulinemia influences blood pressure and serum lipids, it often results in hypertension and dyslipidemia. Therefore, metabolic consequences of obesity and not obesity per se may be the driving forces behind urinary albumin excretion, and even slight abnormalities in glucose metabolism below the diagnostic cutoff for diabetes contributed to the presence of microalbuminuria (34). MA has a strong positive relation to post-challenge alterations in glucose metabolism and overall loss of insulin sensitivity.…”

“…Overweight and obesity are strongly associated with numerous cardiovascular disease risk factors like hyperinsulinemia, impaired glucose metabolism, hypertension, hyperlipidemia and metabolic syndrome, which, apart from predisposing to cardiovascular disease, are also independent risk factors for CKD. Reduced insulin sensitivity represents the most important link between obesity and other metabolic complications leading to renal injury (34). Several studies give strong evidence that obesity, in particular central body fat distribution, is important for renal function abnormalities.…”

Gangguan Ginjal terkait Obesitas pada Anak

“…3 Di Indonesia menurut laporan Riset Kesehatan Dasar (Riskesdas) tahun 2007, prevalensi nasional balita gemuk adalah 12,2% dan prevalensi nasional anak usia sekolah (usia 6-14 tahun) yang gemuk untuk laki-laki 9,5% sedangkan perempuan 6,4%. Menurut Riskesdas tahun 2013, obesitas pada anak sebesar 10,8%.…”