Teen Overweight and Obesity Increase Long-Term ESRD Risk

Very-long-term follow-up shows elevated rates of ESRD for overweight and obese adolescents, according to a report in the Archives of Internal Medicine.

The study included approximately 1.2 million adolescents undergoing examination for compulsory military service in Israel from 1967 through 1997. Linkage to a national ESRD registry was performed to identify incident cases of ESRD between 1980 and 2010, at a mean follow-up time of 25 years. Body mass index at age 17 was evaluated as a predictor of ESRD developing in adulthood.

Treated ESRD was recorded during follow-up in 874 individuals, for an incidence rate of 2.87 per 100,000 person-years. The risk was significantly elevated for participants with overweight or obesity in adolescence. The incidence rates per 100,000 person-years were 6.08 for those in the 85th to 95th percentile of body mass index and 13.40 for those in the 95th percentile or higher.

With adjustment for blood pressure and other variables, the risk for the development of ESRD during follow-up was increased threefold for the overweight group and sevenfold for the obese group: hazard ratio 3.00 and 6.89, respectively. The risk was especially high for diabetic ESRD, HR 5.96 for overweight and 19.37 for obese adolescents, but was also elevated for nondiabetic ESRD, HR 2.17 and 3.41, respectively.

With rising rates of pediatric overweight and obesity, it is important to evaluate the implications for future risk of chronic diseases, including ESRD. The new study shows that overweight and obese adolescents are at increased risk of ESRD, including nondiabetic ESRD, at 25 years’ follow-up. The authors call for further investigation of possible mechanisms, especially because the risk is increased for causes of ESRD apparently unrelated to obesity [Vivante A, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med 2012; 172:1644–1650].

February 2013 (Vol. 5, Number 2)