Published online May 6, 2015. doi: 10.5527/wjn.v4.i2.223
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
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.