ArticleInternational journal of obesity (2005)2026
Early signs of nephropathy in adolescents with obesity.
Article in International journal of obesity (2005), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildhood obesity is increasingly recognized as a risk factor for chronic kidney disease; however, early structural and functional kidney alterations remain incompletely characterized.
methodsWe conducted a cross-sectional study including 768 adolescents with obesity aged 10-18 years. Kidney function (KF) was assessed using creatinine-/cystatin C-based estimated glomerular filtration rate (eGFR), along with urinary albumin- and protein-to-creatinine ratio (ACR, PCR). Kidney length (KL) and volume (KV) were measured by ultrasound and expressed as standard deviation scores (SDS) using reference values.
resultsIncreasing BMI-SDS was associated with lower GFR estimates: creatinine-based eGFR across BMI-SDS categories from 112 to 105 ml/min/1.73 m², cystatin C-based eGFR from 110 to 101 ml/min/1.73 m², and combined creatinine-cystatin C eGFR from 111 to 103 ml/min/1.73 m² (all p < 0.005). Kidney dimensions increased stepwise with adiposity. KL exceeded the 97.5th percentile in 15-19% of participants depending on the reference standards, whereas KV was increased in 48-51% when age-/BSA-based, and 15% when height-based. Albuminuria was uncommon (<5% participants). KV showed significant associations with insulin (r = 0.27), uric acid (r = 0.33), systolic blood pressure (r = 0.33; all p < 0.001). In multivariable linear regression BMI-SDS was independently associated with KV (β = 0.29; 95% CI 0.22-0.36; p < 0.001), inclusion of kidney over-size significantly improved model fit.
conclusionsExcess adiposity is linked to marked kidney enlargement and BMI-related differences in filtration-marker-derived eGFR estimates. Increased KV is frequent despite low prevalence of albuminuria, supporting KV as a sensitive marker of early obesity-related kidney remodeling. The functional significance of lower estimated eGFR values requires confirmation using measured GFR methods.
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