Early markers of obesity-related renal injury in childhood

Abstract

Childhood obesity has become a global epidemic. Recent epidemiological data suggest that obesity is associated with increased risk of renal injury in children. The onset of obesity-associated renal disease is insidious and asymptomatic, so early markers will be extremely useful in its prevention and treatment. Biomarker discovery can be focused on unbiased or biased (candidate) approaches. Unbiased approaches using innovative technologies, such as proteomics and metabolomics, have uncovered candidates that are emerging as plausible biomarkers for such renal disorders as obstructive uropathy and diabetic nephropathy. Biased approaches are based on hypotheses related to glomerular or tubular injury pathophysiology in obesity. Goknar et al. (Pediatric Nephrology 2014; doi: 10.1007/s00467-014-2829 recently evaluated early urine renal injury markers, namely, microalbuminuria, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and kidney injury molecule (KIM)-1, in obese children. They reported that obese children had higher urinary NAG and KIM-1 levels than healthy controls. Longitudinal observation studies are needed to evaluate whether these tubular damage markers are useful as early markers of renal injury in obese children.

Obesity and Diabetic Kidney Disease: Role of Oxidant Stress and Redox Balance

“…6). A targeted metabolomics analysis in both experimental models (2,64) and the human condition of diabetes- (35,53,58) and obesity-related kidney disease (13,66,67) will be very useful to unravel in vivo regulation and translation of critical and relevant pathways of renal disease progression.…”

Renal tubular function and urinary N-acetyl-β-d-glucosaminidase and kidney injury molecule-1 levels in asthmatic children

“…In our study, renal tubular functions and GFR were not affected because neither creatinine nor BUN can change quickly enough during injury due to the fact that individuals with normal renal function have a functional reserve which compensates for nephron injury. 16 In numerous studies evaluating renal hypoxic injury, these values were also within normal limits. [4][5][6][7] The currrent opinion is that serum creatinine is considered to be a poor indicator of acute renal damage or injury.…”

“…This marker could provide detailed data before the occurrence of late consequences of injury like decrease in GFR. 16 Urinary NAG is a lysosomal enzyme that plays a role in the breakdown of glycoproteins in proximal renal tubular cells. It is a high molecular-weight lysosomal enzyme found in many tissues in the body.…”

Metabolomics Reveals thatMomordica charantiaAttenuates Metabolic Changes in Experimental Obesity

“…It has been proven to be of great help to the study of obesity (Zhang et al ., ), to identify early and differential metabolic markers of obesity, and to understand mechanism of obesity occurrence and progression (Duggan et al ., ; Jung et al ., ; Kim et al ., ). Previous metabolomic studies have identified a few molecules to discriminate lean from individual subjects with obesity (Ding and Mak, ; Kim et al ., ; Oberbach et al ., ).…”