ESPN 50th Annual Meeting

ESPN 2017


 
Overweight and obesity associated with renal problems in children
MOSTAFA ELBABA 1

1- WEILL CORNELL MEDICAL COLLEGE IN QATAR
2- HAMAD MEDICAL CORPORATION
 
Introduction:

The effect of overweight especially central obesity on the kidney is well studied in adults and still evolving. In children the obesity related glomerulopathy (ORG) is not fully understood in children. On the other hand, many congenital and hereditary conditions are associated with obesity are there but not gathered yet in any single study. Obesity and overweight are frequently induced by the interventions needed in pediatric nephrology as well.  The purpose of this work is divided to two portions; the first is to review the studies included the effect of obesity on the renal diseases in children. The second portion is to gather all the congenital, hereditary and acquired renal conditions associated with overweight and obesity in children in one systematic review.     

Material and methods:

The obesity related glomerulopathy including the effect of proteinuria, hypertension, nephrolithiasis and kidney cancer were thoroughly reviewed. Extensive search in OMIM; the Online Mendelian Inheritance in Man came up with only seven obesity syndromes associated with renal disorders. The acquired obesity induced by the renal conditions intervention in children was categorized to malnutrition, drug-induced, peritoneal dialysis and issues related to hemodialysis and kidney transplantation.

Results:

The obesity related glomerulopathy is not studied well in children although obese children usually share the same squeals of ORG like adults. The most common of the seven obesity syndromes associated with renal disorders is Bardet–Biedl syndrome.  Unless a pediatric dietician with experience in kidney problem is actively involved in the management of kidney diseases, many children will develop malnutrition towards overweight than underweight in developed countries. Glucocorticoid is the most common drug-induced obesity in pediatric nephrology intervention. peritoneal dialysis and “Let them eat” is the beneficial strategy for hemodialysis. Obesity is a known complication post kidney transplantation and no consensus or guideline is present for the obese kidney donors for children yet.

Conclusions:

 Obesity and overweight in children are horribly increasing every year worldwide. Obesity related glomerulopathy is not studied well in children. Few genetic errors are associated with combined obesity and renal disorders. Pediatric nephrology intervention is frequently associated with overweight in children if it is not actively supervised with the expert pediatric nephrology dietician.