ESPN 50th Annual Meeting

ESPN 2017


 
Long-term lifestyle intervention improves renal function in obese children and adolescents
MARK VAN DAM 1 JESSE RIJKS 1 ELKE DORENBOS 1 FLORE HORUZ 1 KARIN VAN DAEL 1 ANITA VREUGDENHIL 1

1- MAASTRICHT UNIVERSITY MEDICAL CENTRE
 
Introduction:

Weight loss has positive effects on renal function in adults with obesity. In children, the effect of weight loss on renal function is unknown. The aim of this prospective study was to examine the effect of a lifestyle intervention on renal function in children and adolescents with overweight, obesity and morbid obesity.

Material and methods:

245 children and adolescents (mean age 12,30 (2,61-18,69) years, 40,4% boys, BMI z-score 3,46 ± 0.70) participating in an out-patient lifestyle intervention at the Centre for Overweight Adolescent and Children’s Healthcare (COACH) at the Maastricht University Medical Centre were included in the study. Participants with at least 12 months of follow-up (n = 144 (58,8%)) were included in the follow-up study. Mean follow-up period was 15,2 ± 3,9 months. All participants were subjected to detailed history taking, physical examination, anthropometric measurements, blood analysis and blood pressure measurements. Glomerular filtration rate (GFR) was estimated by means of the Schwartz formula.

Results:

At baseline, mean estimated glomerular filtration rate (eGFR) was 116,8 (66,1-189,0) ml/min/1,73m2. 20,8% of the participants demonstrated glomerular hyperfiltration and 2,9% microalbuminuria. After intervention, eGFR decreased significantly from 119,6 to 111,6 ml/min/1,73m2 in the total group of participants. eGFR normalized in 61% of the participants with glomerular hyperfiltration at baseline. eGFR improvement was positively associated with improvement in diastolic blood pressure, fasting glucose and glycated haemoglobin (HbA1c), and was not associated with changes in BMI z-score. No difference in pre- and post-intervention urine albumin-to-creatinine ratio was found.

Conclusions:

After one year of multidisciplinary lifestyle intervention, there is a significant improvement in renal function in children and adolescents with obesity and morbid obesity, which is associated with improvement of cardiovascular risk parameters.