High body-mass index in teens raises the risk of early chronic kidney disease

Obese teenagers have a significantly higher risk of developing early chronic kidney disease (CKD) in young adulthood, according to a large cohort study led by researchers at the Hebrew University of Jerusalem (HU) and Sheba Medical Center at Tel Hashomer.

The study, just published in the prestigious JAMA Pediatrics under the title “Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood,” highlights the importance of lowering the body-mass index (BMI) in teens to better manage the risk of kidney disease for those who are significantly overweight. (BMI is weight in kilograms divided by height in meters squared).

While those with severe obesity appeared to be at higher risk, the researchers also found reason for concern in seemingly healthy young people with a high-normal BMI under 30.

Despite increasing obesity rates in adolescents, data indicating a link to the onset of early chronic kidney disease had been lacking, reports the research team led by Dr. Avishai Tsur of the HU Faculty of Medicine’s military medicine department, who is also a resident at Sheba. “These findings are a harbinger of the potentially preventable, increasing likelihood of developing chronic kidney disease and subsequent cardiovascular disease,” the researchers said.

The study, conducted by colleagues from major health institutions in Israel and the US including Johns Hopkins and Harvard University, included data on 593,660 Israeli adolescents ages 16 to 20, born after January 1, 1975, who had medical assessments for mandatory military service through December 31, 2019, and were insured by Maccabi Healthcare Services.

Findings underscore importance of reducing adolescent obesity rates, researchers say

With a mean follow-up of 13.4 years, 1,963 adolescents (0.3%) overall developed early chronic kidney disease: For males, the risk of developing CKD increased the most with severe obesity (hazard ratio [HR], 9.4). It was also detected with mild obesity (HR, 6.7) and in those who were overweight (HR, 4.0) or had a high-normal BMI in adolescence (HR, 1.8).

Among females, the increased risk was greatest with severe obesity (HR, 4.3), but it was also linked to those who had mild obesity (HR, 2.7), were overweight (HR, 2.3), or had high-normal BMI (HR 1.4).

The findings of this cohort study, the authors concluded, underscore the importance of reducing adolescent obesity rates and managing the risk factors associated with developing CKD.