Debbie Nicholson

Research reveals a six-fold to 19-fold greater risk

Today, one in three American kids and teens are overweight or obese, leading to negative health issues such as heart disease, diabetes, high blood pressure, stroke, some forms of cancer. Teens with elevated BMI’s are now placing themselves at higher risk for end-stage renal disease. End-stage renal disease occurs when the kidneys are no longer able to work at a level needed for everyday life.

View slideshow: Chronic kidney disease causes

According to the study’s background the association between adolescent BMI and the future risk for end-stage renal disease is not fully understood and it is not known the extent to which this association is limited to diabetic ESRD. For the study researchers from the Sheba Medical Centre at Tel Hashomer in Israel, evaluated the link between adolescent BMI and the risk for all-cause diabetic and non-diabetic ERSD.

Dr. Asaf Vivante, M.D., of the Israeli Defense Forces Medical Corps and the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel, and associates examined medical data of about 1,194,704, aged 17, who had been examined for fitness for military service between January 1, 1967 and December 31, 1997 and were linked to the Israeli ESRD registry in a nationwide population-based retrospective study.

During the follow-up the results revealed 713 men and 161 women developed treated ESRD for an overall incidence rate of 2.87 cases per 100,000 persons during more than 30 million follow-up person-years.

Adolescents who were overweight and obese had an increased future risk of ESRD with an incident rates of 6.08 and 3.40 cases per 100,000 person-years, respectively, in comparison to adolescents with normal weight BMI.

Also, researchers had estimated the association between BMI and treated diabetic ESRD and suggest that overweight adolescents at 17 had shown six times greater risk for diabetic ESRD and obese adolescents at 17 had 19 times the greater risk for diabetic ESRD in comparison to those adolescents who were at normal weight.

In their conclusion researchers wrote “Overweight and obesity in adolescents were associated with significantly increased risk for all-cause treated ESRD during a 25-year period. Elevated BMI constitutes a substantial risk factor for diabetic and non-diabetic ESRD.”

Dr. Kristen Lee Johnson, MD, professor of medicine in residence and Director of Dialysis at the San Francisco VA Medical Center, had stated In an invited commentary "The association of obesity with ESRD is good news and bad news.”

The good news is that obesity represents a potentially modifiable risk factor, and control of weight and the hypertension and inactivity that often accompany excess adiposity could prevent or slow the development of some cases of ESRD and may potentially reduce the morbidity and mortality associated with CKD [chronic kidney disease]. The bad news is that it is not easy to address obesity.

Dr. Johnson in conclusion added that there is no evidence that is never too late to improve outcomes by increasing physical activity or shedding pounds, “the results reported by Vivante et al in this issue of the Archives highlight the potential advantages of starting early before chronic disease has developed and unhealthy lifestyles have become lifelong habits.”

This study appears in the Achieves of Internal Medicine.

ESRD almost always follows chronic kidney disease. A person may have gradual worsening of kidney function for 10 - 20 years or more before progressing to ESRD, according to the University of Maryland Medical Center.

Patients who have reached this stage need dialysis or a kidney transplant.

The most common causes of ESRD in the U.S. are diabetes and high blood pressure.

The National Kidney Foundation estimates 20 million Americans or one in nine adults have chronic kidney disease.

More than 400,000 Americans have end-stage renal disease and require dialysis or kidney transplants to stave alive.

By the year 2030, it is estimated 2.24 million Americans will have end-stage renal disease.

More information on ESRD can be found online at the American Kidney Fund.