“Obesity and chronic kidney disease go hand in hand. Apart from the existing non-communicable diseases like diabetes and hypertension, obesity poses a serious threat to kidney health.”  – Dr. Rajashekar Chakravarthi, Sr. Consultant Nephrologist, STAR Hospitals , Hyderabad, India.

 

Below is a Q&A with Dr. Chakravarthi on the eve of World Kidney Day, observed on March 9th.

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Q1. How is the increasing incidence of obesity affecting the kidney?

 

A. Obesity causes kidney disease by more than one mechanism:

 

- It’s more common for obese individuals to have diabetes and hypertension due to their high fat and slow metabolism levels.

 

- Obese individuals have hyperfiltration injury in the kidneys.  For example, if the engine of a small car is used on a bus, the engine will soon fail. Similarly, when kidneys meant to take care of the metabolic needs of a 60 kg person have to take care of the metabolic load of a 90 kg person, they will filter more, leak protein and consequently fail.

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Q2. How do increased fat cells in the body affect the kidney?

 

A. It’s clearly proven that obesity is associated with inflammation. This inflammation is systemic and affects the kidney as well, leading to increased incidence and faster progression of primary kidney disease.

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Q3. The incidence of childhood obesity in India is rising. Does this mean that the younger generations will have kidney failures as well in the future?

 

A. Even childhood obesity is linked to inflammation and hyperfiltration, leading to an earlier onset of diabetes, hypertension and kidney disease. It’s crucial to control obesity in children.

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Q4. What is the total incidence of chronic kidney disease?

 

A. As reported in the SEEK study, the incidence is around 17 to 18 percent. The Care For Your Kidney Foundation has also carried out screenings at the community level in Telangana. Findings suggest that most urban slum inhabitants of Hyderabad—constituting nearly 21% of the general population—suffer from some form of kidney disease or another.

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Q5. What are the major causes of CKD?

 

A. The major causes include diabetes, hypertension, chronic interstitial nephritis, chronic glomerulonephritis, kidney stone disease, urinary tract infections and cystic diseases of the kidney.

 

In recent years, it’s been increasingly accepted that obesity causes kidney disease by itself. Obesity also contributes to the progression of CKD via other causes. For instance, if a patient has diabetic kidney disease, obesity hastens its progression.

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Q6. What are the preventive measures?

 

A. Exercise has a beneficial effect in patients with CKD, especially for those suffering from kidney disease related to obesity. Data shows that exercise reduces inflammation that’s both systemic and kidney-related.

 

Apart from exercise, reducing salt intake, fatty foods and animal protein also help.

 

Obese individuals should get a kidney check at least once a year. They should check their Hb%, serum creatinine, CUE, spot urine protein creatinine ratio and blood pressure levels.

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