Even seemingly healthy teens with high BMI at risk of early CKD

High body mass index (BMI) in late adolescence appears to be a risk factor for chronic kidney disease (CKD) in young adulthood, even for seemingly healthy individuals with a BMI that falls within the normal range but is closer to the upper limit, as reported in a study.

The study included 593,660 participants (mean age at study entry 17.2 years, 54.5 percent men), of which 1,963 (0.3 percent) had early CKD. None of the participants had kidney pathology, albuminuria, hypertension, dysglycemia, or missing blood pressure or BMI data. The mean follow-up duration was 13.4 years.

The risk of developing early CKD among young men was highest for those with severe obesity (adjusted hazard ratio [aHR], 9.4, 95 percent confidence interval [CI], 6.6–13.5), followed by those with mild obesity (aHR, 6.7, 95 percent CI, 5.4–8.4), those with overweight (aHR, 4.0, 95 percent CI, 3.3–5.0), and those with high-normal BMI (aHR, 1.8, 95 percent CI, 1.5-2.2) when compared with those who had normal weight.

Among young women, the risk estimates were lower than that seen among young men but still elevated (severe obesity: aHR, 4.3, 95 percent CI, 2.8–6.5; mild obesity: aHR, 2.7, 95 percent CI, 2.1–3.6; overweight: 2.3, 95 percent CI, 1.9–2.8; high-normal BMI: aHR, 1.4, 95 percent CI, 1.2–1.6).

Consistent results were obtained when analyses were limited to individuals who were seemingly healthy as adolescents, individuals surveyed up to 30 years of age, or those free of diabetes and hypertension at the end of the follow-up.

“[The present data] underscore the long-term sequelae of adolescent obesity, which may be well evident by the late third or early fourth decades of life, even among persons with high-normal BMI in adolescence and without other apparent risk factors for CKD,” the investigators said.

“Given the increasing obesity rates among adolescents, our findings are a harbinger of the potentially preventable increasing burden of CKD and subsequent cardiovascular disease, they added.