title: [Obesity in children and its relationship with chronic kidney disease].
abstract: In the last decades, obesity and chronic kidney disease (CKD) have increased worldwide, in parallel. This article focuses on the current issues of obesity on renal damage, with special emphasis on what happens at pediatric ages. While obesity has been linked closely with type 2 diabetes mellitus and hypertension, reduced insulin sensitivity is a direct mechanism for renal damage. The pathophysiologic mechanisms on renal damage include glomerular hyperfiltration and hypertrophy, hypercellularity and broadening of the mesangial regions, while the lack of sensitivity to insulin increases the effects of angiotensin II, exacerbates proteinuria and induces the production of inflammatory cytokines. Many epidemiological studies have documented the relationship of increased BMI with the development of ERC, but most of these studies have been conducted in adults. In children, the information is scarce, but is consistent with findings in adults. In contrast, there are studies which show that interventions aimed to improve weight loss and limit renal damage and proteinuria is reduced, the blood pressure and glomerular filtration rate. Allthe above make us think on the need to improve efforts to reduce the prevalence of obesity from the early stages of life, which could reduce the number of patients with CKD in the future.
authors.affiliation: Servicio de Escolares y Adolescentes, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. miguel.villasis@imss.gob.mx.
authors.forename: Jessie Nallely
authors.initials: JN
authors.lastname: Zurita-Cruz
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Villasís-Keever
mesh_terms: D002648:Child; D006801:Humans; D063766:Pediatric Obesity / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors
keywords: Adolescent health; Chronic renal insufficiency; Obesity; Pediatrics