Ding W, Cheung WW, Mak RH. Impact of obesity on kidney function and blood pressure in children. World J Nephrol 2015; 4(2): 223-229 [PMID: 25949935 DOI: 10.5527/wjn.v4.i2.223]
Corresponding Author of This Article
Robert H Mak, MD, PhD, Department of Pediatrics, Rady Children’s Hospital, University of California, 9500 Gilman Drive, MC0634, La Jolla, San Diego, CA 92093-0634, United States. romak@ucsd.edu
Research Domain of This Article
Pediatrics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. May 6, 2015; 4(2): 223-229 Published online May 6, 2015. doi: 10.5527/wjn.v4.i2.223
Impact of obesity on kidney function and blood pressure in children
Wei Ding, Wai W Cheung, Robert H Mak
Wei Ding, Wai W Cheung, Robert H Mak, Department of Pediatrics, Rady Children’s Hospital, University of California, San Diego, CA 92093-0634, United States
Wei Ding, Division of Nephrology, the Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200000, China
Author contributions: Ding W reviewed the literature and wrote the draft; all authors edited and commented on the final draft of the manuscript.
Supported by The National Institute of Health, Nos. NIDDK U01DK-3-012 and R24HD050837 (Mak RH).
Conflict-of-interest: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Robert H Mak, MD, PhD, Department of Pediatrics, Rady Children’s Hospital, University of California, 9500 Gilman Drive, MC0634, La Jolla, San Diego, CA 92093-0634, United States. romak@ucsd.edu
Telephone: +1-858-8226717 Fax: +1-858-8226776
Received: November 26, 2014 Peer-review started: November 26, 2014 First decision: December 12, 2014 Revised: February 12, 2015 Accepted: March 4, 2015 Article in press: March 6, 2015 Published online: May 6, 2015
Abstract
In recent years, obesity has become an increasingly important epidemic health problem in children and adolescents. The prevalence of the overweight status in children grew from 5% to 11% from 1960s to 1990s. The epidemic of obesity has been paralleled by an increase in the incidence of chronic kidney disease (CKD) and hypertension. Results of several studies have demonstrated that obesity and metabolic syndrome were independent predictors of renal injury. The pathophysiology of obesity related hypertension is complex, including activation of sympathetic nervous system, renin angiotensin aldosterone system, hyperinsulinemia and inflammation. These same mechanisms likely contribute to the development of increased blood pressure in children. This review summarizes the recent epidemiologic data linking obesity with CKD and hypertension in children, as well as the potential mechanisms.
Core tip: Excess weight gain appears to be a major risk factor for chronic kidney disease and hypertension. The potential mechanisms involve insulin resistance, inflammation, renal renin-angiotensin-aldosterone hyperactivity, and sympathetic nervous system hyperactivity. Increased awareness is needed in children for early diagnosis and implementation of prevention and treatment measures.