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Obesity-Related Health
Problems Can Lead to Kidney Disease

The number of Americans with chronic kidney disease is on the rise, and diabetes and high blood pressure linked to obesity appear to account for most of the increase.

Obesity-Related Health Problems Can Lead to Kidney Disease

The prevalence of chronic kidney disease among US adults has risen in a decade from 10 percent to 13 percent, according to a report in the Journal of the American Medical Association.

"When we looked at how common kidney disease was, we found that it was more common than previously appreciated," says lead researcher Dr. Josef Coresh at Johns Hopkins University.

The aging population is part of the reason for the increased prevalence of kidney disease, notes Dr. Coresh. But, he adds, "There are also substantially higher rates of obesity and diabetes. These are both risk factors for kidney disease."

In addition, more people have high blood pressure, which is often uncontrolled, says Dr. Coresh. High blood pressure can also damage the kidneys.

High Blood Pressure, Diabetes Link
For the study, Dr. Coresh's team collected data on 15,488 people in the 1988 to 1994 National Health and Nutrition Examination Surveys (NHANES).

The researchers then compared these people with 13,233 people who participated in the 1999 to 2004 NHANES survey.

The researchers compared the levels of chronic kidney disease between the two groups.

To establish the presence of kidney disease, Dr. Coresh's group used measures of excess protein in the urine and the glomerular filtration rate, which measures the amount of fluid filtered by the kidneys.

The prevalence of protein in urine and a reduction in the glomerular filtration rate both increased from the first to the second survey.

Overall, the prevalence of chronic kidney disease increased from 10 percent in the 1988-to-1994 survey to 13.1 percent in 1999 to 2004 survey, the researchers say.

The increase in the prevalence of kidney disease appears due to more cases of high blood pressure and diabetes being diagnosed, and much of that is caused by obesity.

This increase in obesity seems to explain the increase in extra protein in the urine but only part of the decrease in the glomerular filtration rate, says Dr. Coresh.

Kidney Disease Prevention a Concern
Chronic kidney disease increases the risk of heart disease as well as kidney failure and other complications.

Currently, there are about 500,000 people with kidney failure who are treated by dialysis or transplantation in the US, and that number is expected to increase to 750,000 by 2015, says Dr. Coresh.

"If diabetes continues to increase, and obesity continues to increase, then it stands to reason that the prevalence of kidney disease will continue to increase," he says.

Dr. Ajay Singh, at Brigham and Women's Hospital in Boston, thinks this study clearly shows the need for more research in preventing and treating chronic kidney disease.

"This data shows that the prevalence of kidney disease is increasing, and that it appears to reflect, at least in part, the increasing incidence of diabetes, high blood pressure, and obesity," says Dr. Singh.

The findings also underscore the importance of early recognition of kidney disease and the need for preventive strategies, explains Dr. Singh.

"Since current treatments only slow down kidney progression, more research dollars need to be allocated to understanding the reasons why kidney disease progresses and how we may be able to prevent it," he concludes.

Always consult your physician for more information.


Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Diabetes Association

American Heart Association

Journal of the American Medical Association – Prevalence of Chronic Kidney Disease in the United States

National Diabetes Information Clearinghouse

National Heart, Lung, and Blood Institute (NHLBI)

National Kidney and Urologic Diseases Information Clearinghouse

National Kidney Foundation

January 2008

What is Diabetes?
Diabetes is a metabolic disorder characterized by a failure to secrete enough insulin, or, in some cases, the cells do not respond appropriately to the insulin that is produced.

Because insulin is needed by the body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood. Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, malnutrition, infections, viruses, or other illnesses.

The three main types of diabetes — type 1, type 2, and gestational — are all defined as metabolic disorders that affect the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body.

In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.

For glucose to be able to move into the cells of the body, the hormone insulin must be present. Insulin is produced primarily in the pancreas, and, normally, is readily available to move glucose into the cells.

However, in persons with diabetes, either the pancreas produces too little or no insulin, or the cells do not respond to the insulin that is produced. This causes a build-up of glucose in the blood, which passes into the urine where it is eventually eliminated, leaving the body without its main source of fuel.

Although the three main types of diabetes are similar in the build-up of blood glucose due to problems with insulin, there are differences in cause and treatment:

type 1 diabetes
Type 1 diabetes is an autoimmune disease in which the body's immune system destroys the cells in the pancreas that produce insulin, resulting in no or a low amount of insulin. People with type 1 diabetes must take insulin daily in order to live.

type 2 diabetes
Type 2 diabetes is a result of the body's inability to make enough, or to properly use, insulin. Type 2 diabetes may be controlled with diet, exercise, and weight loss, or may require oral medications and/or insulin injections.

gestational diabetes
Gestational diabetes occurs in pregnant women who have not had diagnosed diabetes in the past. It results in the inability to use the insulin that is present and usually disappears after delivery. Gestational diabetes may be controlled with diet, exercise, and attention to weight gain. Women with gestational diabetes may be at higher risk for type 2 diabetes later in life.

Diabetes is the sixth leading cause of death among Americans, and the fifth leading cause of death from disease. Although it is believed that diabetes is under-reported as a condition leading to or causing death, each year, more than 200,000 deaths are reported as being caused by diabetes or its complications. Complications of diabetes include eye problems and blindness, heart disease, stroke, neurological problems, amputation, and impotence.

Because diabetes (with the exception of gestational diabetes) is a chronic, incurable disease that affects nearly every part of the body, contributes to other serious diseases, and can be life threatening, it must be managed under the care of a physician throughout a person's life.

Always consult your physician for more information.


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