December 20, 2023 — Adolescent obesity significantly increases the risk of developing early chronic kidney disease (CKD) in young adulthood, according to a large cohort study led by Hebrew University of Jerusalem (HU) researchers.

The new study, published in the prestigious JAMA Pediatrics, highlights the importance of lowering adolescent obesity rates to better manage the risk of kidney disease for adolescents with high body mass index (BMI). While those with severe obesity appear more at risk, researchers also found cause for concern for seemingly healthy individuals with high-normal BMI under 30.

Despite increasing obesity rates in adolescents, data indicating a link to the onset of early chronic kidney disease had been lacking, reports the research team led by Avishai M. Tsur, M.D., of the Hebrew University Department of Military Medicine, Faculty of Medicine. “These findings are a harbinger of the potentially preventable, increasing likelihood of developing chronic kidney disease and subsequent cardiovascular disease,” Dr. Tsur stated.

The study, conducted by colleagues from major health institutions in Israel and the United States, including Johns Hopkins and Harvard University, included data on 593,660 Israeli adolescents ages 16-20, born after January 1, 1975, who had medical assessments for mandatory military service.

With a mean follow-up of 13.4 years, 1,963 adolescents (0.3%) overall developed early chronic kidney disease:

  • For males, the risk of developing CKD increased the most with severe obesity (hazard ratio [HR], 9.4). It was also detected in mild obesity (HR, 6.7), and in those who were overweight (HR, 4.0), or had a high-normal BMI in adolescence (HR, 1.8).
  • Among females, the increased risk was greatest with severe obesity (HR, 4.3). It was also linked to those who had mild obesity (HR, 2.7), were overweight (HR, 2.3), or had high-normal BMI (HR 1.4).

The findings of this cohort study underscore the importance of mitigating adolescent obesity rates and managing the risk factors associated with developing CKD.

JAMA Pediatrics. 2023 Dec 11:e235420. doi: 10.1001/jamapediatrics.2023.5420. Online ahead of print.
Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood
Avishai M Tsur 1,2,3,4, Inbal Akavian 1,2, Regev Landau 1,2,3,4, Estela Derazne 4, Dorit Tzur 1, Asaf Vivante 4,5, Ehud Grossman 3,4, Ran S Rotem 6,7, Boris Fishman 4,8, Orit Pinhas-Hamiel 4,9, Arnon Afek 10, Josef Coresh 11, Gabriel Chodick 4,6, Gilad Twig 1,2,12,13,14
1Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel.
2Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel.
3Department of Medicine, Sheba Medical Center, Tel HaShomer, Israel.
4Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
5Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel.
6Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
7Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
8Division of Cardiology, Sheba Medical Center, Tel HaShomer, Israel.
9Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel.
10Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
11Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
12Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
13Department of Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
14The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel.