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Published on: June 21, 2024
Kidney Considerations in Pediatric Obesity
Alexandra Sawyer1, Evan Zeitler2, Howard Trachtman3
1Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, 13123 East 16Th Avenue, Box 158, Aurora, CO, 80045, USA. Alexandra.sawyer@childrenscolorado.org.
Insights
Obesity-related kidney disease and diabetic kidney disease can affect children, potentially leading to chronic kidney disease later in life. Early detection of kidney injury in pediatric populations is crucial for intervention.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Public Health
Background:
- Chronic kidney disease (CKD) poses significant risks in adults, with children and adolescents also susceptible to early kidney injury.
- Obesity is a key contributor to CKD development through direct and indirect pathways.
- Understanding pediatric kidney disease is vital for long-term health outcomes.
Purpose of the Study:
- To review obesity-related kidney disease (ORKD) and diabetic kidney disease (DKD) in the pediatric population.
- To describe the impact of ORKD and DKD on children and adolescents.
- To highlight the importance of early detection and intervention.
Main Methods:
- Literature review of pediatric obesity and kidney disease.
- Analysis of early kidney injury phenotypes.
- Examination of emerging therapeutic strategies.
Main Results:
- Obesity-related CKD is uncommon in pediatric populations but increases lifetime CKD risk.
- Glomerular hyperfiltration is an early indicator for both ORKD and DKD, preceding albuminuria and GFR decline.
- Novel treatments for pediatric obesity and type 2 diabetes with kidney-protective effects are under investigation.
Conclusions:
- Early kidney damage in pediatric obesity and diabetes can have lasting consequences.
- Identifying early signs like glomerular hyperfiltration is key for timely intervention.
- Further research is needed to fully understand and manage kidney disease in pediatric populations.
Purpose Of Review:
Chronic kidney disease (CKD) is a common condition and a major cause of morbidity and mortality in adults, but children and adolescents are also at risk for early kidney injury and development of CKD. Obesity contributes both directly and indirectly to the development of CKD. The purpose of this review is to describe obesity-related kidney disease (ORKD) and diabetic kidney disease (DKD) and their impact in the pediatric population.
Recent Findings:
Although obesity-related CKD in childhood and adolescence is uncommon, nascent kidney damage may magnify the lifetime risk of CKD. Glomerular hyperfiltration is an early phenotype of both ORKD and DKD and typically manifests prior to albuminuria and progressive decline in GFR. Novel treatments for obesity and type 2 diabetes exerting protective effects on the kidneys are being investigated for use in the pediatric population. It is important to understand the impact of obesity on the kidneys more fully in the pediatric population to help detect injury earlier and intervene prior to the onset of irreversible progression of disease and to guide future research in this area.
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