Measurements taken in teens can predict kidney failure later in life

Kidney failure can be predicted based on measurements taken in adolescence, according to a study published in the November issue of the American Journal of Kidney Diseases.

Researchers found that high blood pressure, being overweight, elevation of a blood marker indicating inflammation, or the presence of protein in the urine in otherwise healthy teenage men were all independent predictors of end-stage renal disease in later in life.

"We were surprised by the magnitude of the risk, especially for individuals with unexplained proteinuria (protein in urine) in adolescence," said Dr. Per-Ola Sundin, lead author of the study and a researcher and physician at Örebro University Hospital. "This shows that silent kidney damage is already occurring in teenagers who won't develop more noticeable symptoms of kidney disease for many years."

The study was based on Swedish male residents in the 1970s who had a physical examination done at the time they enlisted in the military. The majority of these individuals were 18 and 19 years old at the time of testing. Up to 40 years later, researchers identified 534 men who developed ESRD and compared them to a similar group of men who did not develop ESRD.

Analysis of the data showed that the presence of proteinuria in adolescence was associated with a seven-fold increase in the risk of ESRD. Low-grade inflammation found by testing for the erythrocyte sedimentation rate indicated a two-fold increase in kidney failure risk. Hypertension, defined as BP>160/100 and higher, quadrupled the risk of developing ESRD, while a Body Mass Index (BMI) of 30 or above increased ESRD risk by 3.5 times. Although the study was limited to Swedish men, researchers stated there was no biological reason that these findings would not be relevant to females and populations in other industrialized countries.

"We know that chronic kidney disease develops over many years," said Thomas Manley, director of scientific activities, National Kidney Foundation. "If we are able to identify those at the greatest risk for CKD early in life and instill in them the importance of a life long approach to health, progression of kidney issues may be prevented.

"These results suggest that there is a screening opportunity at early an age if we want to prevent chronic kidney disease," said Sundin. "Particularly, proteinuria without an explanation should be followed up by doctors and patients. Also, it is never too early to tackle issues like unhealthy weight gain and hypertension as it may be much harder to begin a healthy lifestyle in later adulthood."