A new study published in JAMA Pediatrics has revealed that high body mass index (BMI) in late adolescence is associated with early chronic kidney disease (CKD) in young adulthood. The study, led by researchers from the Hebrew University of Jerusalem and other institutions, analyzed data from over 629,000 Israeli adolescents aged 16 to 20 who were medically evaluated for mandatory military service.
Chronic kidney disease is a condition that causes gradual loss of kidney function over time. The kidneys are vital organs that filter waste and excess fluid from the blood, regulate blood pressure, and produce hormones. CKD can lead to serious complications such as cardiovascular disease, anemia, bone disease, and kidney failure.
BMI is a measure of body fat based on height and weight. It is used to assess whether a person is underweight, normal weight, overweight, or obese. A high BMI indicates excess body fat, which can increase the risk of various health problems, such as diabetes, hypertension, and cardiovascular disease.
What did the study find?
The study followed the adolescents for a mean of 13.4 years and identified 1,963 cases of early CKD (0.3% of the cohort). Early CKD was defined as stage 1 to 2 CKD based on moderately or severely increased albuminuria, with an estimated glomerular filtration rate of at least 60 mL/min/1.73 m 2.
The researchers found that the risk of developing early CKD increased with higher BMI levels in both males and females. For males, the adjusted hazard ratios for CKD were 1.8, 4.0, 6.7, and 9.4 for adolescents with high-normal BMI, overweight, mild obesity, and severe obesity, respectively. For females, the corresponding hazard ratios were 1.4, 2.3, 2.7, and 4.3.
The association between high BMI and early CKD was consistent even after excluding individuals who had diabetes, hypertension, or other obesity-related risk factors at the end of follow-up. The association was also similar when the cohort was limited to individuals who were seemingly healthy as adolescents, or those surveyed up to 30 years of age.
What are the implications of the study?
The study provides evidence that adolescent obesity is a significant risk factor for early CKD in young adulthood, and that this risk is independent of other common comorbidities. The study also suggests that the risk of CKD increases even with high-normal BMI levels, which may affect a large proportion of the population.
The study highlights the importance of preventing and treating adolescent obesity to reduce the burden of CKD and its complications in the future. The study also calls for more awareness and screening for CKD among young adults, especially those with a history of high BMI in adolescence.
The study authors conclude: “Given the increasing obesity rates among adolescents, our findings are a harbinger of the potentially preventable increasing burden of CKD and subsequent cardiovascular disease”.
