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Scripta Scientifica Medica

Childhood obesity, renal injury and future disease risk

Mina Lateva, Dimitrichka Bliznakova, Sonya Galcheva, Yana Bocheva, Maria Neshkinska, Vilhelm Mladenov, Irina Halvadzhiyan, Galina Yordanova, Veselin Boyadzhiev, Yoto Yotov, Nikolay Conev, Violeta Iotova

Abstract

INTRODUCTION: Evidence associates obesity with glomerular hyperfiltration. Concurrent inflammation, hypertension, dyslipidemia, and insulin resistance represent further established risks to renal health in both children and adults. Our aim was to investigate the relationship between childhood obesity and the risk of renal impairment.

MATERIALS AND METHODS: A total of 114 obese but otherwise healthy children, who were investigated in 2013, were included in the study (mean age 11.5±3.6). Auxology was measured using standard procedures. The pubertal status was defined applying the Tanner scale. Blood and urine tests were performed after overnight fast. Kidney size was measured by standard abdominal ultrasound; kidney volume and estimated glomerular filtration rate were calculated.

RESULTS: Microalbuminuria was detected in 8.5% of the children, and 40.2% of all patients were with high systolic blood pressure (BP). Close to half of the children (43.4%) showed insulin resistance (assessed by HOMA-IR) and 95.4% displayed hyperinsulinism. Kidney volume correlated with waist circumference (WC) (left r=0.636, p<0.001; right r=0.532, p<0.001), as well as with weight and elevated systolic BP. Children with hyperfiltration (9.6% of all) at this stage all had elevated total cholesterol and triglycerides. In further 14.3% of the children (all pubertal) the glomerular filtration rate was low, and they had significantly larger kidney volume (left p<0.001; right p=0.004), HOMA-IR (p=0.001), WC and BMI (p<0.001) compared to those with normal and hyperfiltration rate.

CONCLUSION: To summarize, childhood obesity showed an association with established risk factors for renal toxicity. Whether kidney volume in obese children has an independent predictive value of future chronic kidney disease remains to be investigated.


Keywords

childhood obesity; microalbuminuria; glomerular filtration; kidney volume

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DOI: http://dx.doi.org/10.14748/ssm.v49i1.2050
About The Authors

Mina Lateva
Medical University of Varna
Bulgaria

Department of Pediatrics

Dimitrichka Bliznakova
Medical University of Varna
Bulgaria

Medical College; Department of Pediatrics

Sonya Galcheva
Medical University of Varna
Bulgaria

Department of Pediatrics

Yana Bocheva
Medical University of Varna
Bulgaria

Department of General Medicine and Clinical Laboratory

Maria Neshkinska
Medical University of Varna
Bulgaria

Deapartment of Pediatrics

Vilhelm Mladenov
UMHAT "St. Marina" Varna
Bulgaria

Irina Halvadzhiyan
Medical University of Varna
Bulgaria

Deapartment of Pediatrics

Galina Yordanova
Medical University of Varna
Bulgaria

Deapartment of Pediatrics

Veselin Boyadzhiev
Medical University of Varna
Bulgaria

Deapartment of Pediatrics

Yoto Yotov
Medical University of Varna
Bulgaria

Deapartment of Cardiology

Nikolay Conev
Medical University of Varna
Bulgaria

Deapartment of Propedeutics of internal diseases

Violeta Iotova
Medical University of Varna
Bulgaria

Deapartment of Pediatrics

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