Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, 13123 East 16Th Avenue, Box 158, Aurora, CO, 80045, USA.
Department of Medicine, Division of Nephrology and Hypertension, University of North Carolina Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Curr Obes Rep. 2023 Sep;12(3):332-344. doi: 10.1007/s13679-023-00522-3. Epub 2023 Aug 10.
Chronic kidney disease (CKD) is a common condition and a major cause of morbidity and mortality in adults, but children and adolescents are also at risk for early kidney injury and development of CKD. Obesity contributes both directly and indirectly to the development of CKD. The purpose of this review is to describe obesity-related kidney disease (ORKD) and diabetic kidney disease (DKD) and their impact in the pediatric population.
Although obesity-related CKD in childhood and adolescence is uncommon, nascent kidney damage may magnify the lifetime risk of CKD. Glomerular hyperfiltration is an early phenotype of both ORKD and DKD and typically manifests prior to albuminuria and progressive decline in GFR. Novel treatments for obesity and type 2 diabetes exerting protective effects on the kidneys are being investigated for use in the pediatric population. It is important to understand the impact of obesity on the kidneys more fully in the pediatric population to help detect injury earlier and intervene prior to the onset of irreversible progression of disease and to guide future research in this area.
慢性肾脏病（CKD）是一种常见病症，也是成年人发病率和死亡率的主要原因，但儿童和青少年也有早期肾脏损伤和 CKD 发展的风险。肥胖既直接又间接导致 CKD 的发生。本综述的目的是描述肥胖相关肾脏疾病（ORKD）和糖尿病肾病（DKD）及其在儿科人群中的影响。
尽管儿童和青少年肥胖相关的 CKD 并不常见，但早期的肾脏损伤可能会增加终生患 CKD 的风险。肾小球高滤过是 ORKD 和 DKD 的早期表型，通常在白蛋白尿和 GFR 进行性下降之前出现。正在研究针对肥胖和 2 型糖尿病的新型治疗方法，以保护肾脏，这些方法也将在儿科人群中使用。了解肥胖对儿科人群肾脏的影响更为全面，有助于更早地发现损伤，并在疾病不可逆转进展之前进行干预，从而指导该领域的未来研究，这一点非常重要。
