5 Essential Insights on Obesity and Chronic Kidney Disease in Youngsters

Some form of kidney disease (also known as renal disease) affects 1 in 10 Australians. It’s a term used to describe kidneys that are not functioning properly.

Chronic kidney disease (CKD) indicates a permanent reduction in kidney function. Unfortunately, many thousands of Australian children and teens live with kidney disease or are at risk of developing CKD. In fact, there are links between childhood obesity and chronic kidney disease, which is particularly concerning for youngsters who are in the ‘at risk’ category.

This article provides a deep dive into how obesity can be a significant risk factor for CKD, the underlying mechanisms of this relationship, its long-term health implications, and strategies for prevention and management.

1. The link between obesity and CKD

1 in 4 Australian children between the ages of 2-17 are either overweight or obese, with 1 in 12 considered to be in the obese category. In adults with a BMI (body mass index) higher than 30 is considered in the obese range or in children > 95^th centile depending on age and gender( see Healthy weight calculator for children and teenagers - Healthy Kids for Professionals (nsw.gov.au).

A team of researchers from the Gertner Institute for Epidemiology and Health Policy Research in Israel set out to explore the link between having a high BMI and the early onset of chronic kidney disease. When analysing 593,000 adolescents, researchers measured a protein called albumin in participant’s urine levels. Ineffective filtration of the blood leads to the presence of albumin, which is an indicator of kidney disease.

Previously, this same team of researchers demonstrated an association between a higher BMI in adolescents and kidney disease, detailing a clear link between obesity and CKD. The more obese, the higher the risk. One reason for this is that fat tissue secretes molecules that can accumulate in the organs and cause kidney inflammation.

Furthermore, obesity plays havoc with blood pressure levels and insulin resistance. Along with inflammation caused by fat tissue secretion, these factors combined will harm the kidneys over time. For instance, the body becomes less responsive to the effects of insulin and impaired glucose regulation, which leads to increased fat storage. The result is more fatty secretions to inflame the liver. Of course, fluctuations in blood pressure levels place stress on the body’s organs, including the kidneys.

2. Identifying the risk factors

Now that we’ve established a link between childhood obesity and the possible onset of chronic kidney disease, let’s cover some known risk factors for obesity and CKD in youngsters.

• Genetics: Unfortunately, genetics can be a major contributing factor to CKD, as some 50% of cases of kidney disease in children are hereditary. That’s a large number, no doubt, which is why maintaining an ideal weight at an early age is so critical, so as not to exacerbate the potential problem. Additionally, 1 in 1000 children are born with kidney defects.
• Diet: A poor diet will often lead to weight gain, among other potential medical issues. Over-indulging, eating the wrong kinds of food, drinking sugary and unhealthy drinks and snacking on junk food can all lead to obesity and an increased risk of developing CKD.
• Physical inactivity: A combination of a poor diet with a lack of regular physical activity is a prime recipe for putting on excessive weight. A sedentary lifestyle means burning fewer calories and an increase in total body fat and especially intra-abdominal fat which is associated with insulin resistance and inflammation.
• Socio-economic factors: People from low socio-economic households have a higher propensity for developing health issues, such as cardiovascular disease and obesity. Having overweight parents is often associated with higher risk of having overweight children due to both shared genetic influences as well as shared environment, especially in regard to healthy or unhealthy lifestyles.

3. Long-term health implications

Childhood obesity can ultimately lead to developing some long-term health problems. Carrying around extra body weight for years places stress on all parts of the body. Wear and tear and damage to the joints (such as the knees) can occur. The lungs work harder and the heart is constantly under strain to pump blood through the circulatory system, potentially leading to arterial hypertension, coronary artery disease and heart disease. There is an increased risk of developing diabetes, fatty liver disease and, of course, chronic kidney disease.

With the focus being on the link between childhood obesity and CKD, let’s now cover the health concerns of living with chronic kidney disease.

When damaged, the kidneys cannot filter impurities from the blood as effectively as healthy kidneys. This results in waste and excess fluid building up in the body with potentially life-threatening conditions such as stroke and heart disease being the result. Left untreated, CKD may progress to the point of kidney failure, after which regular dialysis and kidney replacement therapy will be required to sustain life.

4. Prevention strategies

The very best defence against developing CKD is adopting effective weight control methods. Whether your child is currently overweight or obese, or you just want to make sure your child maintains their ideal weight, the following prevention strategies will achieve this outcome.

• Provide a balanced diet: Put some thought into this, as many households will have a pantry and fridge filled with snacks, food and drinks that are unhealthy for everyone. Rather than merely focusing on your child’s eating habits, it’s best if the entire family gets on board and everyone commits to eating a healthy and balanced diet.
• Encourage regular exercise/physical activity: A regular exercise routine along with some physical activities such as sports are necessary to burn calories, speed up the metabolism and reduce body fat levels. Once again, everyone in the family can get involved in staying fit. This way, everything feels more inclusive for a child struggling with weight loss.
• Limit screen time: In an era where everyone’s looking at a screen, the result is too much time spent being inactive. Limit screen time for kids to certain times of the day or so many hours per day.
• Book periodic medical check-ups: Have regular medical check-ups if your child is above their ideal weight or obese. Your doctor will monitor your child’s health and any early diagnosis of a medical condition due to obesity will lead to a more optimistic outcome.

5. World Kidney Day

World Kidney Day takes place on 14 March, 2024. This is an annual global event designed to raise awareness about the importance of good kidney health, the role kidneys play in our bodies, and preventative measures we can take to avoid developing kidney disease and CKD. Here are some ways you can contribute:

• Educate and share information about kidney health
• Undergo regular health screenings
• Engage on social media to spread awareness
• Adopt a healthy lifestyle, with a balanced diet and regular exercise
• Support kidney disease research