Chronic Kidney Disease Predictors in Obese Adolescents

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2022 Feb 25

PMID 35211791

Authors

Katarzyna Mackowiak-Lewandowicz

Danuta Ostalska-Nowicka

Katarzyna Zaorska

Elzbieta Kaczmarek

Jacek Zachwieja

Martin Witt

Michal Nowicki

Affiliations

Soon will be listed here.

Abstract

Background: Glomerular hyperfiltration, initiating development of obesity-related glomerulopathy, results in an enlargement of the glomeruli and unsealing of the filtration barrier. It can be followed by adaptive focal segmental glomerulosclerosis and chronic kidney disease (CKD). The aim of the study was to determine the expression pattern of lipid metabolism and selected kidney damage markers in obese adolescents and to identify potential factors which can predict CKD.

Methods: The study group consisted of 142 adolescents with a BMI z-score > 2. Sixty-two healthy and normal-weight individuals served as controls. The factors associated with the rate of glomerular filtration in obese adolescents were assessed by linear regression methods using univariate and multivariate analyses. The risk of developing CKD was estimated using the Fisher's exact test.

Results: The study group was divided into "elevated," "normal," and "decreased" glomerular filtration rate (GFR) patients. Increased urine galectin-3 (Gal-3) concentration was diagnosed in all patients. "Decreased GFR" subjects expressed increased urine concentration of neutrophil gelatinase-associated lipocalin (NGAL) and daily megalin excretion. Thirty-nine study participants developed CKD. Increased uric acid (UA) concentration was associated with CKD development both in "normal" and "decreased GFR" patients. Additionally, in "normal" GFR patients, increased concentrations of cholesterol (Ch), triglycerides (TG), and NGAL were associated with CKD.

Conclusions: Increased serum concentrations of Ch, TG, and UA and increased urine concentration of NGAL might predict CKD development in obese adolescents with normal and decreased GFR. A higher resolution version of the Graphical abstract is available as Supplementary information.

Citing Articles

Avgoustou E, Tzivaki I, Diamantopoulou G, Zachariadou T, Avramidou D, Dalopoulos V Diagnostics (Basel). 2025; 15(2).

PMID: 39857056 PMC: 11763674. DOI: 10.3390/diagnostics15020169.

Kidney Damage in Pediatric Obesity: Insights from an Emerging Perspective.

Forcina G, Luciano M, Frattolillo V, Mori S, Monaco N, Guarino S J Clin Med. 2024; 13(23).

PMID: 39685484 PMC: 11642363. DOI: 10.3390/jcm13237025.

Kidney function evaluation in children and adolescents with obesity: a not-negligible need.

Barlaba A, Grella C, Tammaro M, Petrone D, Guarino S, Del Giudice E Eur J Pediatr. 2024; 183(9):3655-3664.

PMID: 38871979 DOI: 10.1007/s00431-024-05641-0.

Serum levels of Vanin-2 increase with obesity in relation to inflammation of adipose tissue and may be a predictor of bariatric surgery outcomes.

Geng S, Chen D, Wang Y, Yu X, Zuo D, Lv X Front Nutr. 2023; 10:1270435.

PMID: 38156278 PMC: 10753581. DOI: 10.3389/fnut.2023.1270435.

Childhood Obesity: Insight into Kidney Involvement.

Carullo N, Zicarelli M, Michael A, Faga T, Battaglia Y, Pisani A Int J Mol Sci. 2023; 24(24).

PMID: 38139229 PMC: 10743690. DOI: 10.3390/ijms242417400.

References

Kininmonth A, Smith A, Llewellyn C, Dye L, Lawton C, Fildes A . The relationship between the home environment and child adiposity: a systematic review. Int J Behav Nutr Phys Act. 2021; 18(1):4. PMC: 7788808. DOI: 10.1186/s12966-020-01073-9. View

Clemente-Suarez V, Dalamitros A, Beltran-Velasco A, Mielgo-Ayuso J, Tornero-Aguilera J . Social and Psychophysiological Consequences of the COVID-19 Pandemic: An Extensive Literature Review. Front Psychol. 2021; 11:580225. PMC: 7772398. DOI: 10.3389/fpsyg.2020.580225. View

Qorbani M, Khashayar P, Rastad H, Ejtahed H, Shahrestanaki E, Seif E . Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children and adolescents. Diabetol Metab Syndr. 2020; 12(1):108. PMC: 7720466. DOI: 10.1186/s13098-020-00617-0. View

Hall J, do Carmo J, da Silva A, Wang Z, Hall M . Obesity, kidney dysfunction and hypertension: mechanistic links. Nat Rev Nephrol. 2019; 15(6):367-385. PMC: 7278043. DOI: 10.1038/s41581-019-0145-4. View

Chen H, Liu Z, Zeng C, Li S, Wang Q, Li L . Podocyte lesions in patients with obesity-related glomerulopathy. Am J Kidney Dis. 2006; 48(5):772-9. DOI: 10.1053/j.ajkd.2006.07.025. View

Fukuda A, Chowdhury M, Venkatareddy M, Wang S, Nishizono R, Suzuki T . Growth-dependent podocyte failure causes glomerulosclerosis. J Am Soc Nephrol. 2012; 23(8):1351-63. PMC: 3402293. DOI: 10.1681/ASN.2012030271. View

Kriz W, Hosser H, Hahnel B, Gretz N, Provoost A . From segmental glomerulosclerosis to total nephron degeneration and interstitial fibrosis: a histopathological study in rat models and human glomerulopathies. Nephrol Dial Transplant. 1998; 13(11):2781-98. DOI: 10.1093/ndt/13.11.2781. View

Despres J, Lemieux I . Abdominal obesity and metabolic syndrome. Nature. 2006; 444(7121):881-7. DOI: 10.1038/nature05488. View

de Vries A, Ruggenenti P, Ruan X, Praga M, Cruzado J, Bajema I . Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol. 2014; 2(5):417-26. DOI: 10.1016/S2213-8587(14)70065-8. View

10.

Bobulescu I, Lotan Y, Zhang J, Rosenthal T, Rogers J, Adams-Huet B . Triglycerides in the human kidney cortex: relationship with body size. PLoS One. 2014; 9(8):e101285. PMC: 4149342. DOI: 10.1371/journal.pone.0101285. View

11.

Sun L, Halaihel N, Zhang W, Rogers T, Levi M . Role of sterol regulatory element-binding protein 1 in regulation of renal lipid metabolism and glomerulosclerosis in diabetes mellitus. J Biol Chem. 2002; 277(21):18919-27. DOI: 10.1074/jbc.M110650200. View

12.

Serra A, Romero R, Lopez D, Navarro M, Esteve A, Perez N . Renal injury in the extremely obese patients with normal renal function. Kidney Int. 2008; 73(8):947-55. DOI: 10.1038/sj.ki.5002796. View

13.

Kambham N, Markowitz G, Valeri A, Lin J, DAgati V . Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001; 59(4):1498-509. DOI: 10.1046/j.1523-1755.2001.0590041498.x. View

14.

Praga M, Hernandez E, Morales E, Campos A, Valero M, Martinez M . Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant. 2001; 16(9):1790-8. DOI: 10.1093/ndt/16.9.1790. View

15.

Tsuboi N, Koike K, Hirano K, Utsunomiya Y, Kawamura T, Hosoya T . Clinical features and long-term renal outcomes of Japanese patients with obesity-related glomerulopathy. Clin Exp Nephrol. 2012; 17(3):379-85. DOI: 10.1007/s10157-012-0719-y. View

16.

Friedman A, Chambers M, Kamendulis L, Temmerman J . Short-term changes after a weight reduction intervention in advanced diabetic nephropathy. Clin J Am Soc Nephrol. 2013; 8(11):1892-8. PMC: 3817909. DOI: 10.2215/CJN.04010413. View

17.

Sandokji I, Greenberg J . Novel biomarkers of acute kidney injury in children: an update on recent findings. Curr Opin Pediatr. 2020; 32(3):354-359. DOI: 10.1097/MOP.0000000000000891. View

18.

Nalesso F, Cattarin L, Gobbi L, Fragasso A, Garzotto F, Calo L . Evaluating Nephrocheck as a Predictive Tool for Acute Kidney Injury. Int J Nephrol Renovasc Dis. 2020; 13:85-96. PMC: 7189184. DOI: 10.2147/IJNRD.S198222. View

19.

Dong R, Zhang M, Hu Q, Zheng S, Soh A, Zheng Y . Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review). Int J Mol Med. 2017; 41(2):599-614. PMC: 5752178. DOI: 10.3892/ijmm.2017.3311. View

20.

Suthahar N, Meijers W, Sillje H, Ho J, Liu F, de Boer R . Galectin-3 Activation and Inhibition in Heart Failure and Cardiovascular Disease: An Update. Theranostics. 2018; 8(3):593-609. PMC: 5771079. DOI: 10.7150/thno.22196. View