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Kidney Considerations in Pediatric Obesity

  • REVIEW
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Abstract

Purpose of Review

Chronic kidney disease (CKD) is a common condition and a major cause of morbidity and mortality in adults, but children and adolescents are also at risk for early kidney injury and development of CKD. Obesity contributes both directly and indirectly to the development of CKD. The purpose of this review is to describe obesity-related kidney disease (ORKD) and diabetic kidney disease (DKD) and their impact in the pediatric population.

Recent Findings

Although obesity-related CKD in childhood and adolescence is uncommon, nascent kidney damage may magnify the lifetime risk of CKD. Glomerular hyperfiltration is an early phenotype of both ORKD and DKD and typically manifests prior to albuminuria and progressive decline in GFR. Novel treatments for obesity and type 2 diabetes exerting protective effects on the kidneys are being investigated for use in the pediatric population.

Summary

It is important to understand the impact of obesity on the kidneys more fully in the pediatric population to help detect injury earlier and intervene prior to the onset of irreversible progression of disease and to guide future research in this area.

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Funding

P.B. receives salary and research support from NIDDK (R01 DK129211, R01 DK132399, R21 DK129720, K23 DK116720, UC2 DK114886, P30-DK116073), NHLBI (R01 HL165433), JDRF (3-SRA-2022-1097-M-B, 3-SRA-2022-1243-M-B, 3-SRA-2022-1230-M-B), Boettcher Foundation, American Heart Association (20IPA35260142), Ludeman Family Center for Women’s Health Research at the University of Colorado, the Department of Pediatrics, Section of Endocrinology and Barbara Davis Center for Diabetes at University of Colorado School of Medicine.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, 13123 East 16Th Avenue, Box 158, Aurora, CO, 80045, USA

    Alexandra Sawyer & Petter Bjornstad

  2. Department of Medicine, Division of Nephrology and Hypertension, University of North Carolina Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Evan Zeitler

  3. Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA

    Howard Trachtman

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  1. Alexandra Sawyer
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  2. Evan Zeitler
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  3. Howard Trachtman
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  4. Petter Bjornstad
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The first draft of the manuscript was written by Alexandra Sawyer and Petter Bjornstad and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexandra Sawyer.

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Conflict of Interest

Petter Bjornstad reports serving or having served as a consultant for AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Eli-Lilly, LG Chemistry, Sanofi, Novo Nordisk, and Horizon Pharma. Petter Bjornstad also serves or has served on the advisory boards and/or steering committees of AstraZeneca, Bayer, Boehringer Ingelheim, Novo Nordisk, and XORTX. Evan Zeitler reports that his spouse receives research funding from VtV Therapeutics, Novo Nordisk, Rhythm Pharmaceuticals, and Dexcom. All other authors declare no competing interests.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Sawyer, A., Zeitler, E., Trachtman, H. et al. Kidney Considerations in Pediatric Obesity. Curr Obes Rep 12, 332–344 (2023). https://doi.org/10.1007/s13679-023-00522-3

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