Browse > Article
http://dx.doi.org/10.3345/cep.2021.00108

Obesity and chronic kidney disease: prevalence, mechanism, and management  

Yim, Hyung Eun (Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine)
Yoo, Kee Hwan (Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.64, no.10, 2021 , pp. 511-518 More about this Journal
Abstract
The prevalence of childhood obesity is increasing worldwide at an alarming rate. While obesity is known to increase a variety of cardiovascular and metabolic diseases, it also acts as a risk factor for the development and progression of chronic kidney disease (CKD). During childhood and adolescence, severe obesity is associated with an increased prevalence and incidence of the early stages of kidney disease. Importantly, children born to obese mothers are also at increased risk of developing obesity and CKD later in life. The potential mechanisms underlying the association between obesity and CKD include hemodynamic factors, metabolic effects, and lipid nephrotoxicity. Weight reduction via increased physical activity, caloric restriction, treatment with angiotensin-converting enzyme inhibitors, and judicious bariatric surgery can be used to control obesity and obesity-related kidney disease. Preventive strategies to halt the obesity epidemic in the healthcare community are needed to reduce the widespread deleterious consequences of obesity including CKD development and progression.
Keywords
Fetal development; Intergenerational relations; Pediatric obesity; Proteinuria; Renal insufficiency;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Verani RR. Obesity-associated focal segmental glomerulosclerosis: pathological features of the lesion and relationship with cardiomegaly and hyperlipidemia. Am J Kidney Dis 1992;20:629-34.   DOI
2 Adeosun SO, Gordon DM, Weeks MF, Moore KH, Hall JE, Hinds TD Jr, et al. Loss of biliverdin reductase-A promotes lipid accumulation and lipotoxicity in mouse proximal tubule cells. Am J Physiol Renal Physiol 2018;315:F323-31.   DOI
3 Knop MR, Geng TT, Gorny AW, Ding R, Li C, Ley SH, et al. Birth weight and risk of type 2 diabetes mellitus, cardiovascular disease, and hypertension in adults: a meta-analysis of 7 646 267 participants from 135 studies. J Am Heart Assoc 2018;7:e008870.   DOI
4 Pabalan N, Tiongco RE, Pandac JK, Paragas NA, Lasta SL, Gallego N, et al. Association and biomarker potential of elevated serum adiponectin with nephropathy among type 1 and type 2 diabetics: a meta-analysis. PLoS One 2018;13:e0208905.   DOI
5 de Vries AP, Ruggenenti P, Ruan XZ, Praga M, Cruzado JM, Bajema IM, et al. Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol 2014;2:417-26.   DOI
6 Gai Z, Wang T, Visentin M, Kullak-Ublick GA, Fu X, Wang Z. Lipid accumulation and chronic kidney disease. Nutrients 2019;11:722.   DOI
7 Noor S, Alam F, Fatima SS, Khan M, Rehman R. Role of leptin and dyslipidemia in chronic kidney disease. Pak J Pharm Sci 2018;31:893-97.
8 Mohseni R, Mohammed SH, Safabakhsh M, Mohseni F, Monfared ZS, Seyyedi J, et al. Birth weight and risk of cardiovascular disease incidence in adulthood: a dose-response meta-analysis. Curr Atheroscler Rep 2020;22:12.   DOI
9 Elshenawy S, Simmons R. Maternal obesity and prenatal programming. Mol Cell Endocrinol 2016;435:2-6.   DOI
10 Wong MG, The NL, Glastras S. Maternal obesity and offspring risk of chronic kidney disease. Nephrology 2018;23 Suppl 4:84-7.   DOI
11 Hsu CW, Yamamoto KT, Henry RK, De Roos AJ, Flynn JT. Prenatal risk factors for childhood CKD. J Am Soc Nephrol 2014;25:2105-11.   DOI
12 Starr MC, Hingorani SR. Prematurity and future kidney health: the growing risk of chronic kidney disease. Curr Opin Pediatr 2018;30:228-35.   DOI
13 Glastras SJ, Chen H, McGrath RT, Zaky AA, Gill AJ, Pollock CA, et al. Effect of GLP-1 receptor activation on offspring kidney health in a rat model of maternal obesity. Sci Rep 2016;6:23525.   DOI
14 Glastras SJ, Tsang M, Teh R, Chen H, McGrath RT, Zaky AA, et al. Maternal obesity promotes diabetic nephropathy in rodent offspring. Sci Rep 2016;6:27769.   DOI
15 Yim HE, Yoo KH. Early life obesity and chronic kidney disease in later life. Pediatr Nephrol 2015;30:1255-63.   DOI
16 World Health Organization. Obesity and overweight [Internet]. Geneva (Switzerland): World Health Organization; 2020 [cited 2020 Apr 1]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
17 Umer A, Kelley GA, Cottrell LE, Giacobbi P Jr, Innes KE, Lilly CL. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis. BMC Public Health 2017;17:683.   DOI
18 Nehus E, Mitsnefes M. Childhood obesity and the metabolic syndrome. Pediatr Clin North Am 2019;66:31-43.   DOI
19 Zelle DM, Klaassen G, van Adrichem E, Bakker SJ, Corpeleijn E, Navis G. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol 2017;13:152-68.   DOI
20 Glastras SJ, Chen H, Pollock CA, Saad S. Maternal obesity increases the risk of metabolic disease and impacts renal health in offspring. Biosci Rep 2018;38:BSR20180050.   DOI
21 Bolignano D, Zoccali C. Effects of weight loss on renal function in obese CKD patients: a systematic review. Nephrol Dial Transplant 2013;28 Suppl 4:iv82-98.   DOI
22 Brenner BM, Lawler EV, Mackenzie HS. The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 1996;49:1774-7.   DOI
23 Lalan S, Jiang S, Ng DK, Kupferman F, Warady BA, Furth S, et al. Cardiometabolic risk factors, metabolic syndrome, and chronic kidney disease progression in children. J Pediatr 2018;202:163-70.   DOI
24 Trinchieri A, Croppi E, Montanari E. Obesity and urolithiasis: evidence of regional influences. Urolithiasis 2017;45:271-8.   DOI
25 Chagnac A, Zingerman B, Rozen-Zvi B, Herman-Edelstein M. Consequences of glomerular hyperfiltration: the role of physical forces in the pathogenesis of chronic kidney disease in diabetes and obesity. Nephron 2019;143:38-42.   DOI
26 Bluher M. The distinction of metabolically "healthy" from "unhealthy" obese individuals. Curr Opin Lipidol 2010;21:38-43.   DOI
27 Xiao Y, Liu D, Cline MA, Gilbert ER. Chronic stress, epigenetics, and adipose tissue metabolism in the obese state. Nutr Metab (Lond) 2020;17:88.   DOI
28 Hallow KM, Gebremichael Y, Helmlinger G, Vallon V. Primary proximal tubule hyperreabsorption and impaired tubular transport counterregulation determine glomerular hyperfiltration in diabetes: a modeling analysis. Am J Physiol Renal Physiol 2017;312:F819-35.   DOI
29 Lee KK, Raja EA, Lee AJ, Bhattacharya S, Bhattacharya S, Norman JE, et al. Maternal obesity during pregnancy associates with premature mortality and major cardiovascular events in later life. Hypertension 2015;66:938-44.   DOI
30 Chong LSH, Sautenet B, Tong A, Hanson CS, Samuel S, Zappitelli M, et al. Range and heterogeneity of outcomes in randomized trials of pediatric chronic kidney disease. J Pediatr 2017;186:110-17.e11.   DOI
31 Chang AR, Chen Y, Still C, Wood GC, Kirchner HL, Lewis M, et al. Bariatric surgery is associated with improvement in kidney outcomes. Kidney Int 2016;90:164-71.   DOI
32 Mallamaci F, Ruggenenti P, Perna A, Leonardis D, Tripepi R, Tripepi G, et al. ACE inhibition is renoprotective among obese patients with proteinuria. J Am Soc Nephrol 2011;22:1122-8.   DOI
33 Wanner C, Tonelli M, Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. KDIGO clinical practice guideline for lipid management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int 2014;85:1303-9.   DOI
34 Imam TH, Fischer H, Jing B, Burchette R, Henry S, DeRose SF, et al. Estimated GFR before and after bariatric surgery in CKD. Am J Kidney Dis 2017;69:380-8.   DOI
35 Vallon V, Thomson SC. The tubular hypothesis of nephron filtration and diabetic kidney disease. Nat Rev Nephrol 2020;16:317-36.   DOI
36 Farkhondeh T, Llorens S, Pourbagher-Shahri AM, Ashrafizadeh M, Talebi M, Shakibaei M, et al. An overview of the role of adipokines in cardiometabolic diseases. Molecules 2020;25:5218.   DOI
37 Kazmi A, Sattar A, Hashim R, Khan SP, Younus M, Khan FA. Serum leptin values in the healthy obese and non-obese subjects of Rawalpindi. J Pak Med Assoc 2013;63:245-8.
38 Mao S, Fang L, Liu F, Jiang S, Wu L, Zhang J. Leptin and chronic kidney diseases. J Recept Signal Transduct Res 2018;38:89-94.   DOI
39 Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 2013;128:1689-712.   DOI
40 NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in bodymass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 2017;390:2627-42.   DOI
41 Tsujimoto T, Sairenchi T, Iso H, Irie F, Yamagishi K, Watanabe H, et al. The dose-response relationship between body mass index and the risk of incident stage ≥3 chronic kidney disease in a general Japanese population: the Ibaraki prefectural health study (IPHS). J Epidemiol 2014;24:444-51.   DOI
42 Wang Y, Chen X, Song Y, Caballero B, Cheskin LJ. Association between obesity and kidney disease: a systematic review and meta-analysis. Kidney Int 2008;73:19-33.   DOI
43 Pilitsi E, Farr OM, Polyzos SA, Perakakis N, Nolen-Doerr E, Papathanasiou AE, et al. Pharmacotherapy of obesity: available medications and drugs under investigation. Metabolism 2019;92:170-92.   DOI
44 Pratt JS, Lenders CM, Dionne EA, Hoppin AG, Hsu GL, Inge TH, et al. Best practice updates for pediatric/adolescent weight loss surgery. Obesity 2009;17:901-10.   DOI
45 Shah S, Hussain T. Enhanced angiotensin II-induced activation of Na+, K+-ATPase in the proximal tubules of obese Zucker rats. Clin Exp Hypertens 2006;28:29-40   DOI
46 Jung UJ, Choi MS. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease. Int J Mol Sci 2014;15:6184-223.   DOI
47 Nehus EJ, Khoury JC, Inge TH, Xiao N, Jenkins TM, Moxey-Mims MM, et al. Kidney outcomes three years after bariatric surgery in severely obese adolescents. Kidney Int 2017;91:451-58.   DOI
48 Bjornstad P, Nehus E, van Raalte D. Bariatric surgery and kidney disease outcomes in severely obese youth. Semin Pediatr Surg 2020;29:150883.   DOI
49 Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol 2018;14:12-24   DOI
50 Woodard K, Louque L, Hsia DS. Medications for the treatment of obesity in adolescents. Ther Adv Endocrinol Metab 2020;11:2042018820918789.
51 Abitbol CL, Chandar J, Rodriguez MM, Berho M, Seeherunvong W, Freundlich M, et al. Obesity and preterm birth: additive risks in the progression of kidney disease in children. Pediatr Nephrol 2009;24:1363-70.   DOI
52 Chang A, Van HL, Jacobs DR Jr, Liu K, Muntner P, Newsome B, et al. Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study. Am J Kidney Dis 2013;62:267-75.   DOI
53 Song SH, Oh TR, Choi HS, Kim CS, Ma SK, Oh KH, et al. High serum adiponectin as a biomarker of renal dysfunction: Results from the KNOW-CKD study. Sci Rep 2020;10:5598.   DOI
54 Lu J, Zhang S, Li W, Leng J, Wang L, Liu H, et al. Maternal gestational diabetes is associated with offspring's hypertension. Am J Hypertens 2019;32:335-42.   DOI
55 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011;128(Suppl 5):S213-56.   DOI
56 Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ. Weight in infancy and death from ischaemic heart disease. Lancet 1989;2:577-80.
57 Bonthuis M, van Stralen KJ, Verrina E, Groothoff JW, Alonso Melgar A, Edefonti A, et al. Underweight, overweight and obesity in paediatric dialysis and renal transplant patients. Nephrol Dial Transpl 2013;28:195-204.
58 Yang S, Cao C, Deng T, Zhou Z. Obesity-related glomerulopathy: a latent change in obesity requiring more attention. Kidney Blood Press Res 2020;45:510-22.   DOI
59 Nielsen R, Christensen EI, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int 2016;89:58-67.   DOI
60 Gepstein V, Weiss R. Obesity as the main risk factor for metabolic syndrome in children. Front Endocrinol 2019;10:568.   DOI
61 Assadi F. The growing epidemic of chronic kidney disease: preventive strategies to delay the risk for progression to ESRD. Adv Exp Med Biol 2019;1121:57-9.   DOI
62 Tain YL, Hsu CN. Developmental origins of chronic kidney disease: should we focus on early Life? Int J Mol Sci 2017;18:381.   DOI
63 Templin T, Cravo Oliveira Hashiguchi T, Thomson B, Dieleman J, Bendavid E. The overweight and obesity transition from the wealthy to the poor in low- and middle-income countries: a survey of household data from 103 countries. PLoS Med 2019;16:e1002968.   DOI
64 Correia-Costa L, Azevedo A, Caldas Afonso A. Childhood obesity and impact on the kidney. Nephron 2019;143:8-11.   DOI
65 Barlow SE, Expert C. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164-92.   DOI
66 Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol 2020;19:79.   DOI
67 Garofalo C, Borrelli S, Minutolo R, Chiodini P, De Nicola L, Conte G. A systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population. Kidney Int 2017;91:1224-35.   DOI
68 Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet 2014;384:755-65.   DOI
69 Ladhani M, Craig JC, Irving M, Clayton PA, Wong G. Obesity and the risk of cardiovascular and all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Nephrol Dial Transplant 2017;32:439-49.   DOI
70 Maring B, Greenspan LC, Chandra M, Daniels SR, Sinaiko A, Prineas RJ, et al. Comparing US paediatric and adult weight classification at the transition from late teenage to young adulthood. Pediatr Obes 2015;10:371-9.   DOI
71 Ayina CN, Noubiap JJ, Etoundi Ngoa LS, Boudou P, Gautier JF, Mengnjo MK, et al. Association of serum leptin and adiponectin with anthropomorphic indices of obesity, blood lipids and insulin resistance in a Sub-Saharan African population. Lipids Health Dis 2016;15:96.   DOI
72 Wolf G, Ziyadeh FN. Leptin and renal fibrosis. Contrib Nephrol 2006;151:175-83.   DOI
73 Lee MP, Orlov D, Sweeney G. Leptin induces rat glomerular mesangial cell hypertrophy, but does not regulate hyperplasia or apoptosis. Int J Obes 2005;29:1395-401.   DOI
74 Berthoux F, Mariat C, Maillard N. Overweight/obesity revisited as a predictive risk factor in primary IgA nephropathy. Nephrol Dial Transplant 2013;28 Suppl 4:iv160-6.
75 Vivante A, Golan E, Tzur D, Leiba A, Tirosh A, Skorecki K, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med 2012;172:1644-50.   DOI
76 Kambham N, Markowitz G, Valeri A, Lin J, D'Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 2001;59:1498-509.   DOI
77 Hong S, Choi YM, Ihm SH, Kim D, Choi MG, Yu JM, et al. Association between metabolic parameters and glomerular hyperfiltration in a representative Korean population without chronic kidney disease. PLoS One 2018;13:e0207843.   DOI
78 Wu C, Wang AY, Li G, Wang L. Association of high body mass index with development of interstitial fibrosis in patients with IgA nephropathy. BMC Nephrol 2018;19:381.   DOI
79 Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med 2006;144:21-8.   DOI
80 Camara NO, Iseki K, Kramer H, Liu ZH, Sharma K. Kidney disease and obesity: epidemiology, mechanisms and treatment. Nat Rev Nephrol 2017;13:181-90.   DOI
81 GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2020;395:709-33.   DOI
82 Rodriguez-Gonzalez GL, Reyes-Castro LA, Bautista CJ, Beltran AA, Ibanez CA, Vega CC, et al. Maternal obesity accelerates rat offspring metabolic ageing in a sex-dependent manner. J Physiol 2019;597:5549-63.   DOI
83 Look AHEAD Research Group. Effect of a long-term behavioural weight loss intervention on nephropathy in overweight or obese adults with type 2 diabetes: a secondary analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol 2014;2:801-9.   DOI
84 Kim JY, Cho H. Effect of hypertension on childhood-onset systemic lupus erythematous in a tertiary medical center in Korea. Child Kidney Dis 2020;24:107-14.   DOI
85 Lee MJ, Yim HE, Yoo KH. A case of renal cortical necrosis in a 15-year-old boy with acute kidney injury. Child Kidney Dis 2019;23:53-7.   DOI
86 Xu T, Sheng Z, Yao L. Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment. Front Med 2017;11:340-8.   DOI
87 Jing Y, Jin S, Qiao R, Fang J. Association of adipocytokines with obesity and insulin resistance in Korean-Chinese and Han nationality pupils of Yanbian area. Wei Sheng Yan Jiu 2015;44:581-5.
88 Glastras SJ, Chen H, Tsang M, Teh R, McGrath RT, Zaky A, et al. The renal consequences of maternal obesity in offspring are overwhelmed by postnatal high fat diet. PLoS One 2017;12:e0172644.   DOI
89 Liu B, Qiao J, Hu J, Fan M, Zhao Y, Su H, et al. Leptin promotes endothelial dysfunction in chronic kidney disease by modulating the MTA1-mediated WNT/β-catenin pathway. Mol Cell Biochem 2020;473:155-66.   DOI
90 Esfahani M, Movahedian A, Baranchi M, Goodarzi MT. Adiponectin: an adipokine with protective features against metabolic syndrome. Iran J Basic Med Sci 2015;18:430-42.
91 Kuo IC, Wu PH, Lin HY, Niu SW, Huang JC, Hung CC, et al. The association of adiponectin with metabolic syndrome and clinical outcome in patients with non-diabetic chronic kidney disease. PLoS One 2019;14:e0220158.   DOI
92 Choi SR, Lim JH, Kim MY, Kim EN, Kim Y, Choi BS, et al. Adiponectin receptor agonist AdipoRon decreased ceramide, and lipotoxicity, and ameliorated diabetic nephropathy. Metabolism 2018;85:348-60.   DOI
93 Li Z, Woollard JR, Wang S, Korsmo MJ, Ebrahimi B, Grande JP, et al. Increased glomerular filtration rate in early metabolic syndrome is associated with renal adiposity and microvascular proliferation. Am J Physiol Renal Physiol 2011;301:F1078-87.   DOI
94 Chou HH, Chiou YY, Chiou YH, Tain YL, Wang HH, Yu MC, et al. Mortality risks among various primary renal diseases in children and adolescents on chronic dialysis. J Clin Med 2018;7:414.   DOI
95 Eisner BH, Eisenberg ML, Stoller ML. Relationship between body mass index and quantitative 24-hour urine chemistries in patients with nephrolithiasis. Urology 2010;75:1289-93.   DOI
96 D'Agati VD, Chagnac A, de Vries AP, Levi M, Porrini E, Herman-Edelstein M, et al. Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016;12:453-71.   DOI
97 Yim HE, Han KD, Kim B, Yoo KH. Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea. Epidemiol Health 2021;43:e2021005.
98 Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA 2005;293:455-62.   DOI
99 Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008;371:569-78.   DOI
100 Nam GE, Cho KH, Han K, Kim CM, Han B, Cho SJ, et al. Obesity, abdominal obesity and subsequent risk of kidney cancer: a cohort study of 23.3 million East Asians. Br J Cancer 2019;121:271-7.   DOI
101 Kwakernaak AJ, Toering TJ, Navis G. Body mass index and body fat distribution as renal risk factors: a focus on the role of renal haemodynamics. Nephrol Dial Transplant 2013;28 Suppl 4:iv42-9.
102 Helal I, Fick-Brosnahan GM, Reed-Gitomer B, Schrier RW. Glomerular hyperfiltration: definitions, mechanisms and clinical implications. Nat Rev Nephrol 2012;8:293-300.   DOI