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儿童和青少年肥胖患者的肾功能评估:不容忽视的需求。

Kidney function evaluation in children and adolescents with obesity: a not-negligible need.

机构信息

Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

Eur J Pediatr. 2024 Sep;183(9):3655-3664. doi: 10.1007/s00431-024-05641-0. Epub 2024 Jun 13.

Abstract

UNLABELLED

The role of obesity as risk factor for chronic kidney disease (CKD) has been well-recognized. As previously demonstrated in adults, emerging data highlighted the relevant impact of obesity on renal function since childhood. As a matter of fact, obesity also affects renal health through a complex pathogenic mechanism in which insulin resistance (IR) plays a pivotal role. Worthy of note, the vicious interplay among obesity, IR, and renal hemodynamics clinically translates into a plethora of kidney function impairments potentially leading to CKD development. Therefore, renal injury needs to be added to the well-known spectrum of cardiometabolic obesity comorbidities (e.g., type 2 diabetes, IR, metabolic syndrome, cardiovascular disease).

CONCLUSION

Taking this into account, a careful and timely monitoring of kidney function should not be neglected in the global assessment of children with obesity. We aimed to provide a comprehensive overview on the relevance of kidney evaluation in children with obesity by shedding lights on the intriguing relationship of obesity with renal health in this at-risk population.

WHAT IS KNOWN

• Obesity has been found to be a risk factor for chronic kidney disease. • Unlike adults, pediatric data supporting the association between obesity and renal function are still limited.

WHAT IS NEW

• As observed in adults, obesity might affect renal function since childhood. • Kidney function should be carefully evaluated in children with obesity.

摘要

背景

肥胖是慢性肾脏病(CKD)的一个风险因素,这一点已得到广泛认可。既往研究已表明,肥胖对儿童时期的肾功能有一定影响。事实上,肥胖还通过胰岛素抵抗(IR)这一复杂的发病机制影响肾脏健康。值得注意的是,肥胖、IR 和肾脏血液动力学之间的恶性循环在临床上会导致多种肾功能损害,从而可能导致 CKD 的发生。因此,肾脏损伤需要被添加到肥胖相关的已知的代谢心血管合并症(如 2 型糖尿病、IR、代谢综合征、心血管疾病)谱中。

结论

鉴于此,在对肥胖儿童进行全面评估时,不应忽视对其肾功能的仔细和及时监测。我们旨在通过阐明肥胖与该高危人群的肾脏健康之间的关系,为肥胖儿童的肾脏评估相关性提供全面的概述。

已知情况

肥胖被认为是 CKD 的一个危险因素。与成人不同,肥胖与肾功能相关的儿科数据仍十分有限。

新发现

与成人观察到的情况一样,肥胖可能自儿童时期起就会影响肾功能。肥胖儿童应仔细评估其肾功能。

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