Glomerular filtration rate and cardiometabolic risk in an outpatient pediatric population with high prevalence of obesity

Abstract

Objective: To evaluate the relationship between estimated glomerular filtration rate (eGFR) and cardiometabolic risk factors (CMRF) in an outpatient pediatric population with high prevalence of obesity. Design and Methods: eGFR was evaluated in 901 children unselected for chronic kidney disease of whom 694 were overweight=obese (6-16 years) and 207 were age-and sex-matched normal weight (NW). We generated three categories of eGFR: mild-low eGFR (< 20th percentile), high eGFR (>80th percentile) and intermediate eGFR (20-80th percentile), considered as the reference category Results: Children with either mild-low or high eGFR category showed a 2-4 fold higher Odds ratio of high blood pressure, left ventricular hypertrophy, and microalbuminuria compared with children of the intermediate eGFR category. In addition, children with mild-low eGFR levels showed a 1.5-2 fold higher Odds ratio of impaired fasting glucose and high white blood cell count compared with children with intermediate eGFR levels. Conclusions: In outpatient children with high prevalence of obesity, children with either mildly reduced or high eGFR have an increased burden of CMRF. Children with eGFR < 97 mL=min=1.73 m 2 show a worse CMR profile. This finding supports the usefulness to assess eGFR to identify children with unfavorable CMR profile.

High-normal estimated glomerular filtration rate and hyperuricemia positively correlate with metabolic impairment in pediatric obese patients

“…Therefore, previous reports have clearly shown that adulthood obesity is associated with glomerular hyper-perfusion and hyper-filtration as an early sign of physiologic maladaptation leading, in part, to afferent arteriolar vasodilatation [ 1 ]. Of note, we show that microalbuminuria was present only in subjects with eGFR > 0 SD in good agreement with a previous report [ 29 ]. Thus, our findings, together with the observation that childhood obesity positively correlates with a fast decline of eGFR over time, with a 2- to -3 fold higher risk of developing ESRD [ 30 ], should prompt physicians to evaluate the possibility of renal dysfunction in obese children.…”

Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review

“…Some other studies consider obesity as a risk factor for albuminuria. In 2014, a study in 901 children aged 6–16 years, 565 of whom were obese, found no difference in albuminuria levels with or without obesity [ 33 ]. However, these authors determined that albuminuria was directly related with glomerular filtration rate [ 33 ].…”

“…In 2014, a study in 901 children aged 6–16 years, 565 of whom were obese, found no difference in albuminuria levels with or without obesity [ 33 ]. However, these authors determined that albuminuria was directly related with glomerular filtration rate [ 33 ]. Additionally, the prevalence of albuminuria in overweight and obese infants has been shown to be 2.7–4%, which does not differ significantly from estimations in the general population [ 34 , 35 ].…”

Prevalence of Albuminuria in Children Living in a Rural Agricultural and Fishing Subsistence Community in Lake Chapala, Mexico

“…Although the latter has been established as a method of scrutiny in Asiatic countries, international consensus does not yet exist on its use [ 15 ]. In the international literature, the association has been mentioned of albuminuria with environmental [ 16 , 17 , 18 , 19 , 20 ], demographic [ 21 , 22 , 23 , 24 , 25 ], infectious [ 26 , 27 , 28 ], non-infectious [ 29 , 30 , 31 , 32 , 33 ], and congenital [ 34 , 35 , 36 , 37 , 38 , 39 , 40 ] type factors.…”