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Obese teens more likely to develop end-stage kidney disease

Overweight and obese teens may be setting themselves up for a future of kidney disease, according to a new study.

Researchers found that teens who carried extra weight at the time they were 17 were more likely to have all-cause treated end-stage renal disease (ESRD), also known as chronic kidney failure, as adults.

In the U.S., 17 percent of of children and adolescents aged 2 through 19 years are obese, according to the Centers for Disease Control and Prevention. Obesity prevalence has tripled since the 1980s. The researchers point out that obese children often grow into obese adults, who are at a higher risk for chronic illnesses such as diabetes, leading to a future risk of chronic kidney disease and ESRD.

The researchers looked at almost 1.2 million 17-year-olds who were given fitness exams for the Israeli military service between January 1967 and December 1997. Overweight or obese status was determined using the Body Mass Index (BMI) test.The same individuals were also listed in a nationwide Israeli ESRD registry. The study followed each subject for about an average of 25 years.

Out of all the test subjects, 874 people -- 2.87 cases per 100,000 person-years -- developed ERSD. However, those who were overweight or obese as a teen had higher rates of 3.00 and 6.89 per 100,000 person-years respectively.

The number jumped considerably when just looking at ERSD caused by diabetes. Overweight and obese adolescents had an incidence rate of 6.08 and 13.4 per 100,000 person-years respectively. Overall, overweight adolescents at 17 years old had six times the risk and obese adolescents at 17 years old had 19 times the risk for diabetic ESRD.

"We should not underestimate how much harm obesity can cause in our children and young adults. That is definitely something that this paper conveys," says Dr. Halima Janjua, physician at the Cleveland Clinic Children's Hospital, in Cleveland, Ohio, said to WebMD. She was not involved in the study.

In an invited commentary, Dr. Kirsten L. Johansen, a nephrologist at the San Francisco Veterans Affairs Medical Center, said it's possible that obese people were hypertensive -- meaning they had high blood pressure -- and that is known to cause kidney disease. She added people might be able to modify their behavior to avoid kidney disease, but it would be hard work. However, starting a healthier lifestyle earlier may lead to long-term good habits.

"The association of obesity with ESRD is good news and bad news. The good news is that obesity represents a potentially modifiable risk factor, and control of weight and the hypertension and inactivity that often accompany excess [fat] could prevent or slow the development of some cases of ESRD...The bad news is that it is not easy to address obesity," Johansen explained.

Dr. David Katz, director of the Yale University Prevention Research Center, argued to HealthDay that the study associated weight with kidney failure, but did not prove that it caused it. Nevertheless, it still showed the risks of excess weight, even at a young age.

"I'm not sure we really need yet another reason to recognize epidemic obesity as an enormous threat to human health, and an enormous cost center. But this study suggests we have one," Katz, who was not involved in the study, said.

The study was published online on Oct. 29 in the Archives of Internal Medicine.

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