Obese young adults unaware of kidney disease risk, study finds

Many young adults with abdominal obesity have albuminuria, yet the vast majority don’t know they’re at risk for further kidney damage, according to a study of nationwide health data led by Albert Einstein College of Medicine researchers that was published online in the journal PLOS ONE.

Einstein researchers analyzed health data on nearly 7,000 non-pregnant young adults. They found that 11% of obese Mexican Americans have albuminuria. This is four times the prevalence in Hispanics of normal weight. About 6% of whites and blacks with abdominal obesity had elevated levels of the protein.

The researchers found that excess albumin was present even in the urine of obese individuals with normal blood pressure, glucose levels, and insulin sensitivity, confirming a direct connection between obesity and the albuminuria associated with kidney disease. These findings also suggest that obesity should be considered an independent risk factor for CKD and that doctors should be testing for kidney damage when evaluating obese young adults, the study authors said.

The researchers analyzed health data on 6,918 non-pregnant adults ages 20 to 40. The data were gathered between 1999 and 2010 by the National Health and Nutrition Examination Survey (NHANES), a program of studies designed to assess the health and nutritional status of adults and children in the United States. The participants self-identified as non-Hispanic white, non-Hispanic black, or Mexican-American. Abdominal obesity (defined as a waist circumference ≥102 cm (40 inches) in males and ≥88 cm (35 inches) in females) was present in 45 percent of blacks, 40% of Mexican-Americans, and 37% of whites.

“Even though chronic kidney disease typically manifests in older people, the disease can start much earlier but often is not recognized early on,” said study leader Michal L. Melamed, MD, associate professor of medicine and of epidemiology & public health at Einstein and attending physician, nephrology at Montefiore Health System. “Because treatment options for CKD are limited, prevention is the best approach for those at risk. A healthier lifestyle in young adults will go a long way toward promoting kidney health later in life.”

The study also found that among all young adults with albuminuria, fewer than 5% had ever been told they have kidney disease. “Clearly, clinicians and public health officials need to do more to identify and treat young people at risk for early progressive kidney disease so they can adopt the behavioral changes to prevent CKD from occurring,” said Dr. Melamed.