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Overweight teenagers are more likely to develop end stage renal disease decades later

BMJ 2012; 345 doi: (Published 31 October 2012) Cite this as: BMJ 2012;345:e7289

A nationwide cohort study in Israel found that teenagers who were overweight or obese at their health check for military service were significantly more likely to develop end stage renal disease over the next 25 years than those of normal weight. Researchers studied 1.2 million 17 year olds who were examined for military service and interviewed between 1967 and 1997. Eight hundred and seventy four developed end stage renal disease before the end of May 2010, an incidence of 2.87 per 100 000. Risk was tripled in overweight teenagers (6.08 per 100 000; hazard ratio 3.00, 95% CI 2.50 to 3.60) and increased almost sevenfold in those who were obese (13.4 per 100 000; 6.89, 5.52 to 8.59).

Overweight and obesity at 17 years of age were powerfully associated with end stage renal disease caused by diabetes. They were also linked to other causes of end stage renal disease, and a linked editorial implicates hypertension, smoking, inactivity, and poor diet as likely mediating factors (doi:10.1001/2013.jamainternmed.917). The researchers had data on blood pressure at age 17 years and adjusted their analyses accordingly. But they couldn’t account for blood pressure later in life, or for the unhealthy lifestyles that generally accompany obesity and overweight.

Although the absolute risk of end stage renal disease looks low, these figures don’t capture the effect of obesity and overweight on chronic kidney disease, a much more prevalent condition that precedes end stage disease, says the editorial. Protecting renal function is one more reason to encourage teenagers (and everyone else) to eat less and move more.


Cite this as: BMJ 2012;345:e7289

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