Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Nov 26;172(21):1644-50.
doi: 10.1001/2013.jamainternmed.85.

Body mass index in 1.2 million adolescents and risk for end-stage renal disease

Asaf Vivante  1 , Eliezer Golan, Dorit Tzur, Adi Leiba, Amir Tirosh, Karl Skorecki, Ronit Calderon-Margalit
Affiliations

Body mass index in 1.2 million adolescents and risk for end-stage renal disease

Asaf Vivante et al. Arch Intern Med. .

Abstract

Background: The relationship between adolescent body mass index (BMI) and future risk for end-stage renal disease (ESRD) is not fully understood, nor is it known the extent to which this association is limited to diabetic ESRD. We evaluated the association between BMI in adolescence and the risk for all-cause, diabetic, and nondiabetic ESRD.

Methods: Medical data about 1 194 704 adolescents aged 17 years who had been examined for fitness for military service between January 1, 1967, and December 31, 1997, were linked to the Israeli ESRD registry in this nationwide population-based retrospective cohort study. Incident cases of treated ESRD between January 1, 1980, and May 31, 2010, were included. Cox proportional hazards models were used to estimate the hazard ratio (HR) for treated ESRD among study participants for their BMI at age 17 years, defined in accord with the US Centers for Disease Control and Prevention BMI for age and sex classification.

Results: During 30 478 675 follow-up person-years (mean [SD], 25.51 [8.77] person-years), 874 participants (713 male and 161 female) developed treated ESRD, for an overall incidence rate of 2.87 cases per 100 000 person-years. Compared with adolescents of normal weight, overweight adolescents (85th to 95th percentiles of BMI) and obese adolescents (≥95th percentile of BMI) had an increased future risk for treated ESRD, with incidence rates of 6.08 and 13.40 cases per 100 000 person-years, respectively. In a multivariate model adjusted for sex, country of origin, systolic blood pressure, and period of enrollment in the study, overweight was associated with an HR of 3.00 (95% CI, 2.50-3.60) and obesity with an HR of 6.89 (95% CI, 5.52-8.59) for all-cause treated ESRD. Overweight (HR, 5.96; 95% CI, 4.41-8.06) and obesity (HR, 19.37; 95% CI, 14.13-26.55) were strong and independent risk factors for diabetic ESRD. Positive associations of overweight (HR, 2.17; 95% CI, 1.71-2.74) and obesity (HR, 3.41; 95% CI, 2.42-4.79) with nondiabetic ESRD were also documented.

Conclusions: Overweight and obesity in adolescents were associated with significantly increased risk for all-cause treated ESRD during a 25-year period. Elevated BMI constitutes a substantial risk factor for diabetic and nondiabetic ESRD.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative incidence of treated end-stage renal disease (ESRD) among participants according to body mass index percentile subgroup. Log-rank P < .001.
Figure 2
Figure 2
Hazard ratios for diabetic and nondiabetic end-stage renal disease (ESRD) by body mass index (BMI) percentile subgroup. Model 2 is adjusted for sex, country of origin, period of enrollment in the study, and systolic blood pressure (above or below the 95th age-specific and sex-specific percentiles). Black boxes indicate significant results (P < .001).
See this image and copyright information in PMC

Comment in

References

    1. Abelson P, Kennedy D. The obesity epidemic. Science. 2004;304(5676):1413. - PubMed
    1. Haslam DW, James WP. Obesity. Lancet. 2005;366(9492):1197–1209. - PubMed
    1. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in over-weight among US children and adolescents, 1999-2000. JAMA. 2002;288(14):1728–1732. - PubMed
    1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 2006;295(13):1549–1555. - PubMed
    1. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003-2006. JAMA. 2008;299(20):2401–2405. - PubMed