Adolescent obesity can lead to chronic kidney diseases in young adults: Study

Hyderabad: A high body mass index (BMI) during late adolescence can augment the risk of early chronic kidney diseases (CKD) in young adulthood, according to a new study published online this December in JAMA Pediatrics. The study found the risk in apparently healthy patients with high-normal BMI before the age of 30.

Avishai M Tsur from the Faculty of Medicine, Tel Aviv University, Israel and his colleagues collaborated in this study, which investigated if adolescent BMI was linked to early CKD in young adults below 45 years of age.

Nearly 6 lakh adolescents evaluated, 54.5 per cent males

This cohort study examined data from Israel’s national health care systems CKD registry and linked it with data from the mandatory medical evaluations of adolescents, aged 16 to 20 years (mean age 17.2 years), born after January 1975.

The BMI was calculated and categorised by age and sex-matched percentiles as per the CDC. A total of 6,29,168 adolescents were evaluated, of which 5,93,660 were included in the present analysis. Over half (54.5 per cent) of the study group was male, said Dr Sanjay Kalra, president of the South Asian Federation of Endocrine Societies (SAFES) and endocrinologist at Bharti Hospital, Karnal, Haryana.

CKD found in 0.3 per cent in young adulthood

Out of the total population included in the study, 1,963 adolescents (0.3 per cent) developed early CKD, which was the main outcome of the study, over the mean follow-up duration of 13.4 years. Early CKD was defined as stage 1 to 2 CKD with an estimated glomerular filtration (urine formation) rate (eGFR) of 60 mL/min/1.73 m2 or greater and moderately or severely increased albuminuria (a sign of kidney disease indicating excess albumen protein in urine), informed Dr Kalra, commenting on the study.

CKD risk directly proportional to increased weight

The study found that overweight male adolescents were four times more likely to develop CKD with an adjusted hazard ratio (aHR) of 4.0. The risk increased nearly seven-fold among adolescents with mild obesity (aHR 6.7) and rose nearly 10 times in those with severe obesity (aHR 9.4).

In male adolescents with high-normal BMI, the aHR for CKD was 1.8. Analysis of the female participants showed aHR of 2.3 for adolescent girls with overweight, 2.7 for those with mild obesity and 4.3 for girls who had severe obesity, observed Dr Nitin Kapoor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College (CMS) Vellore.

When the cohort was restricted to those who appeared healthy as teenagers, people surveyed up to the age of 30 years, or people who did not have diabetes or hypertension after the follow-up, the results remained the same.

Significance of the study: need for reducing adolescent obesity

This study has linked high BMI in late adolescence to early development of CKD in young adulthood. The risk was high in adolescents who were seemingly healthy with a high-normal BMI. The risk was greater in subjects with obesity and increased further as the severity of obesity increased.

Based on these findings, adolescent obesity therefore may be regarded as a risk factor for early CKD in young adults. This highlights the importance of addressing and reducing obesity among adolescents. Managing risk factors for kidney disease in adolescents with high BMI can mitigate the likelihood of CKD, including cardiovascular events later on in life, pointed out medical experts.