Obese teenagers can develop chronic kidney disease – 12/19/2023 – Balance and Health

Obesity in adolescence is a serious risk factor for the development of chronic kidney disease in the first years of adulthood, shows a new study published in Jama (Journal of the American Medical Association).

After monitoring 600,000 patients, Israeli researchers discovered that a high body mass index (BMI) is associated with up to five times more kidney damage before the age of 30.

According to Benito Lourenço, a doctor specializing in adolescence (hebiatrist) at the Institute for Children and Adolescents at USP’s Hospital das Clínicas, the number of cases of obesity among adolescents has increased in recent years.

Obesity is a serious and complex condition, caused by a series of factors, such as a sedentary lifestyle and unhealthy diet, but family history, socioeconomic status and environmental factors also influence it.

Fat accumulation is a risk factor for a series of health problems, including diabetes, cardiovascular problems and hypertension. Israeli research sought to understand the relationship between obesity and chronic kidney disease.

Adolescents aged between 16 and 20 years without previous kidney disease were included. Patient monitoring began in 2000 and ended only in 2020. Over an average of 13 years, almost 2,000 (0.3%) of participants developed chronic kidney disease.

The results show that the risk rate for both men and women doubles in overweight people and can reach up to five times higher among those with severe obesity.

Andreia Watanabe, medical coordinator of the pediatric nephrology unit at USP’s Hospital das Clínicas, highlights the robustness of the results. “We already knew that obesity in adults increases the progression of chronic kidney disease, and now we know that it is a risk factor in adolescents as well.”

The doctor remembers that the research still has some limitations. Firstly, urine tests carried out among participants can generate some bias in the results.

Another problem is regarding the use of BMI to measure obesity. Although it is a good parameter for population studies, it should not be the only indicator in individual cases, because it does not reveal the real percentage of fat accumulated by the patient.

Even though there are limitations, for the doctor the results are important, as chronic kidney disease has advanced throughout the world. Today, it is estimated that one in ten people has the disease, many still without knowing it.

In addition to obesity, hypertension and diabetes are also risk factors. In children, prematurity and low birth weight should alert parents.

Among people who have risk factors, closer monitoring of kidney health is recommended. Kidney function can be assessed by urinalysis or blood creatinine concentration. “Kidney disease does not cause symptoms. When it does present symptoms, it is already at a very advanced stage”, recalls Watanabe.

But it’s not just chronic kidney disease that can result from obesity in adolescence. Another study from this year shows that the accumulation of fat in the first years of life is associated with an increase in the incidence of various types of cancer by 33% in adulthood, and mortality by 28%.

The hypothesis raised is that chronic inflammation caused by fat may have the underlying consequence of the emergence of tumors, but more studies are still needed to confirm this.

To avoid risks, the best solution is to seek treatment, explains the pediatric endocrinologist at USP University Hospital, Louise Cominato.

In addition to lifestyle changes — physical activity, healthy eating, healthy sleep — treatments are also available in more serious cases, including for teenagers.