Pediatric nephrology patients are overweight: 20 years' experience in a single Canadian tertiary pediatric nephrology clinic

Filler, Guido; Reimão, Sílvia Mansur; Kathiravelu, Anusha; Grimmer, Joanne; Feber, Janusz; Drukker, Alfred

doi:10.1007/s11255-007-9258-y

Cited by 29 publications

(18 citation statements)

References 21 publications

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“…Currently, the proportion of overweight and obese Norwegian TX children is twice that of the general Norwegian child population [52]. TX children are probably exposed to the same trends as the general population in terms of the obesity epidemic and a sedentary lifestyle [53,54].…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children

et al. 2010

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Children with renal transplants (TX) are at increased risk of cardiovascular (CV) disease. Study objectives were to assess the level of cardiorespiratory fitness (CR fitness) and daily physical activity (PA) in renal TX children and adolescents in relation to traditional cardiovascular risk factors. Laboratory testing included assessment of CR fitness by treadmill exercise testing (VO(2peak)), 24-h ambulatory blood-pressure (ABPM) measurement, oral glucose tolerance test (OGTT), anthropometrics and measurement of lipid levels. PA was self-reported by questionnaire. Twenty-two TX patients with a median (range) age 14.5 (9-18) years were tested. Median V0(2peak) was 66% (36-97) of the expected values compared with controls. Nineteen (86%) children reported <60 min of daily moderate to vigorous physical activity (MVPA). Sixteen (73%) were hypertensive and 8 (34%) were overweight or obese. Four children fulfilled the criteria for a metabolic syndrome. Children with at least 2 of the 3 metabolic risk factors (hypertension, overweight, and glucose intolerance, n=7) achieved significantly lower VO(2peak) compared with those with one or none of these factors (median V0(2peak) 45% and 73% of the expected values respectively, p=0.003). Renal TX children and adolescents have severely impaired CR fitness and PA. Reduced CR fitness was associated with the clustering of CV risk factors. Routine counseling for increased PA is strongly recommended.

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Section: Discussionmentioning

confidence: 99%

Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children

et al. 2010

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“…Of particular concern, Filler et al [43] recently reported a significant increase in BMI z-score in their pediatric nephrology population over the last three decades, with an overall BMI z-score higher than the comparable USA young population in the same period. This puts young nephrology patients at even greater risk of developing CKD later in life than could be depicted from their renal disease only.…”

Section: Obesity-related Renal Injury In Childhoodmentioning

confidence: 99%

Obesity-Related Renal Injury in Childhood

Sereno

Pelliccia²,

Chiarelli³

et al. 2010

Horm Res Paediatr

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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.

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“…Hsu et al demonstrated the effect of body mass index (BMI) on the risk of end-stage renal disease in a cohort of 330,252 persons in California between 1964 and 1985, reporting a strong doseresponse relationship between the baseline BMI and the risk of chronic kidney disease (CKD) [2]. Filler et al demonstrated that pediatric renal patients had significantly higher BMI zscores than the normal population at a tertiary center in Canada over a period of 2 decades [3]. In children with renal transplants, kidney samples obtained from obese donors (BMI >30) had a lower glomerular filtration rate (GFR) and higher allograft dysfunction rate than kidney samples obtained from lean individuals (BMI <25) [4].…”

Section: Introductionmentioning

confidence: 99%

Early markers of obesity-related renal injury in childhood

Ding

Mak

2014

Pediatr Nephrol

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Childhood obesity has become a global epidemic. Recent epidemiological data suggest that obesity is associated with increased risk of renal injury in children. The onset of obesity-associated renal disease is insidious and asymptomatic, so early markers will be extremely useful in its prevention and treatment. Biomarker discovery can be focused on unbiased or biased (candidate) approaches. Unbiased approaches using innovative technologies, such as proteomics and metabolomics, have uncovered candidates that are emerging as plausible biomarkers for such renal disorders as obstructive uropathy and diabetic nephropathy. Biased approaches are based on hypotheses related to glomerular or tubular injury pathophysiology in obesity. Goknar et al. (Pediatric Nephrology 2014; doi: 10.1007/s00467-014-2829 recently evaluated early urine renal injury markers, namely, microalbuminuria, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and kidney injury molecule (KIM)-1, in obese children. They reported that obese children had higher urinary NAG and KIM-1 levels than healthy controls. Longitudinal observation studies are needed to evaluate whether these tubular damage markers are useful as early markers of renal injury in obese children.

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Pediatric nephrology patients are overweight: 20 years' experience in a single Canadian tertiary pediatric nephrology clinic

Cited by 29 publications

References 21 publications

Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children

Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children

Obesity-Related Renal Injury in Childhood

Early markers of obesity-related renal injury in childhood

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