Late-adolescent weight categories and early kidney disease in young adulthood: a nationwide study of Arab and Jewish Israelis.

BACKGROUND

Previous reports have demonstrated that childhood obesity is associated with early chronic kidney disease. The aim of the study was to assess the relationship between weight categories in late adolescence and early chronic kidney disease (CKD) during young adulthood (age 30 years and younger) in individuals of Jewish and Arab ethnicity in Israel, on a nationwide level.

METHODS

This retrospective cohort study included 102,902 adolescents aged 17-19 years - 47,892 of Jewish ethnicity and 53,492 of Arab ethnicity, born between 1988 and 1992 and insured by Clalit Health Services. Early CKD was defined when two urine albumin-to-creatinine ratio tests showed ≥ 30 mg/g within six months of an eGFR test ≥ 60 mL/min/1.73 m2.

RESULTS

The incidence (95% CI) of early CKD was higher among adolescents of Arab than of Jewish ethnicity at 52.3 (46.7-58.4) and 34.6 (29.8-39.9) cases per 105 person-years, respectively. The risk for early CKD grew progressively, in adjusted to socio-economic variables models, increasing to HRs (95% CI) of 14.63 (8.86-24.15), and 9.75 (5.35-17.78) in the 'class 3 obesity' category among individuals of Arab and Jewish ethnicity, respectively. Sensitivity analyses among participants who had at least one microalbumin-creatinine ratio test and among participants who didn't develop hypertension and diabetes mellitus during follow-up showed similar patterns.

CONCLUSIONS

The findings emphasize the necessity of actions designed to decrease the prevalence of adolescent overweight and obesity, especially in the Arab ethnic minority in Israel. Adolescents with obesity should be monitored closely for signs of early CKD.