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Overweight adolescents at increased risk for end-stage renal disease
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The link between BMI and future risk for end-stage renal disease in adolescents is not entirely clear. However, new data published in the Archives of Internal Medicine report that overweight or obese adolescents had an increased risk for all-cause treated end-stage renal disease (ESRD) and that elevated BMI is a significant risk factor.
Asaf Vivante, MD, from the Israeli Defense Forces Medical Corps and the Edmond and Lily Safra Children’s Hospital at Sheba Medical Center in Tel Hashomer, Israel, and colleagues reviewed the medical data of approximately 1.2 million adolescents who had been examined for military service between January 1967 and December 1997.
“During 30,478,675 follow-up person-years, 875 participants (713 male and 161 female) developed treated ESRD, for an overall incidence rate of 2.87 cases per 100,000 person-years,” the researchers wrote.
According to data, overweight adolescents showed an increased future risk of 6.08 (per 100,000 person-years) for treated ESRD, and obese adolescents showed an increased future risk of 13.4 cases (per 100,000 person-years), compared with adolescents of normal weight.
After adjustments, the HRs for all-cause treated ESRD among overweight and obese patients were 3 (95% CI, 2.5-3.6) and 6.89 (95% CI, 5.52-8.59).
Researchers also wrote that overweight (HR=5.96; 95% CI, 4.41-8.06) and obesity (HR=19.37; 95% CI, 14.13-26.55) were found to be independent risk factors for ESRD with diabetes. However, positive associations between overweight, obese and patients without ESRD with diabetes were reported as well, they wrote.
In an accompanying editorial, Kirsten L. Johansen, MD, from the nephrology section of San Francisco Veterans Affairs Medical Center, wrote that the results reported by Vivante and colleagues highlight the possible advantages of starting physical activity and weight loss goals early in life.
“Increasing physical activity among adolescents and young adults has the potential to address obesity directly, as well as to prevent or ameliorate hypertension and diabetes, which undoubtedly account for some of the observed association between obesity and ESRD,” Johansen wrote.
Vivante and colleagues suggest further studies to examine the relationship between childhood obesity and the development of chronic kidney disease and ESRD.
For more information:
Johansen KL. Arch Intern Med. 2012;doi:10.1001/2013.jamainternmed.917.
Vivante A. Arch Intern Med. 2012;doi:10.1001/2013.jamainternmed.85.
Disclosure:The researchers report no relevant financial disclosures.