Two children with obesity‐related glomerulopathy identified in a school urinary screening program

Abstract

The incidence of obesity-related glomerulopathy (ORG) has increased over the last decade, but there have been few reports on ORG in Japanese children. Reported herein are two children with ORG identified on school urinary screening (SUS). Patient 1 was a 12-year-old boy in whom proteinuria was first detected on SUS. His body mass index (BMI) was 33.8 kg/m(2) and he had hypertension and hyperuricemia. Patient 2, a 10-year-old boy, also had proteinuria identified on SUS. His BMI was 34.8 kg/m(2) , and he had fatty liver, hyperuricemia, and hypercholesterolemia. Both were diagnosed with ORG based on obesity, proteinuria, and renal pathological findings. After treatment, including candesartan, food restriction and physical exercise, urinary protein excretion was decreased in both cases. We believe that such school urinary screening programs may be effective for the early identification and treatment of children with ORG.

Zinc delays the progression of obesity‐related glomerulopathy in mice via down‐regulating P38 MAPK‐mediated inflammation

“…Limited clinic case reports showed that proteinuria was usually first detected and common in child ORG patients with or without hematuria, hyperuricemia, hypertension, and dyslipidemia. Renal biopsies of ORG patients have demonstrated glomeruli hypertrophy, proliferation of mesangial cells, and mesangial matrix expansion with or without segmental sclerosis ; these histologic changes are similar with what we observed in the present study. Meta‐analysis has shown that obesity could be associated with the development of renal dysfunction in childhood .…”

Hemodynamics as Measured With Color Doppler Sonography in Early‐Stage Obesity‐Related Nephropathy in Children

“…Microalbuminuria has been shown to be a sensitive marker of early-stage damage to the glomeruli, and it increases as kidney disease worsens. 21 This study demonstrated that the urine albumin in the obesity-related nephropathy group was higher than that in the control group, was positively correlated with the RI, and increased as microproteinuria increased. Therefore, the RI can indirectly reflect early-stage glomerular damage.…”

“…This lack of a difference might have been because the time since diagnosis was relatively short in all selected cases. Microalbuminuria has been shown to be a sensitive marker of early‐stage damage to the glomeruli, and it increases as kidney disease worsens . This study demonstrated that the urine albumin in the obesity‐related nephropathy group was higher than that in the control group, was positively correlated with the RI, and increased as microproteinuria increased.…”

The Renal Pathology of Obesity: Structure-Function Correlations

“…ORG often occurs in young to middle-aged adults, with a male predominance; however, it can occur in all age groups, including children and elderly individuals. 17,23,24 The frequent background comorbidities of ORG patients include hypertension and dyslipidemia. 6−11 In general, the initial obesity-associated kidney phenotype is characterized as isolated proteinuria (without hematuria) with or without a GFR decrease.…”