The World Kidney Day (9th March) theme for 2017 of: Kidney Disease and Obesity – Healthy Lifestyle for Healthy Kidneys, promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviors an affordable option and life-improving strategy benefiting the 10% of the world’s population living with chronic kidney disease, and the millions at risk of developing kidney failure.

Obesity and Kidney Disease: preventing one will reduce the prevalence of the other

Obesity has become a worldwide epidemic affecting more than 600 million adults worldwide, and the prevalence is projected to increase in coming years: during the next decade a further increase in obesity of 40% or more may occur. Obesity is a well-known risk factor for noncommunicable diseases such as diabetes, high blood pressure and heart disease. A less well recognized (but equally important) complication of obesity and these particular NCDs is chronic kidney disease (CKD).

Kidneys are amazing, and important. Their main job is to filter and remove toxins and excess water from your blood, producing urine. Blood pressure stabilisation, red blood cell production and bones all benefit from the work of kidneys. So if kidneys stop working properly, the symptoms can be life-endangering.

The filters in kidneys can carry an extra load if a few get damaged, but if damage continues, then the kidneys and their function can start failing. If loss of kidney function is detected early and managed well, it can be slowed and sometimes stopped (though not fully cured). Kidney disease can be hard to detect early, particularly in resource poor settings, and if it leads to kidney failure, dialysis treatment or a kidney transplant is required to ensure the body continues to filter waste and prevent toxins building up. People with kidney disease are also at increased risk of cardiovascular disease, and thus premature death.

CKD: the 3^rd most rapidly increasing cause of mortality

Obesity may cause chronic kidney disease through various ways. On the one hand, it could contribute to it indirectly, by inducing or worsening diabetes and hypertension, themselves well-recognized risk factors of kidney disease. On the other hand, obesity could also cause kidney damage directly, by placing an unduly high burden on the kidneys over many years (a larger body needs more kidney function after all), and also by causing harmful metabolic changes such as inflammation and oxidation. As a testament to the important role played by obesity in the development of chronic kidney disease, the frequency of the so-called obesity-related glomerulopathy (a term reflecting the microscopic changes found in individuals whose kidneys were damaged by obesity) has increased ten-fold in recent years. Besides its now well-recognized role in the development of chronic kidney disease, obesity has also been shown to be a risk factor for other kidney conditions including kidney stones and cancer. Reducing obesity will improve kidney health and prevent NCDs.

Awareness, prevention and policy regulations are key to kidney health and the fight against obesity

It is now clear that successful weight loss can result in improved control of diabetes and of high blood pressure, and it can lower the risk for developing chronic kidney disease. Patients with chronic kidney disease experience numerous severe complications, such as high risk for heart disease and vascular disease, high death rates, and low quality of life. Given the clear evidence implicating obesity in the development and worsening of numerous illnesses (including kidney diseases), without doubt, prevention and treatment of obesity should be prioritized by individuals, by healthcare providers and by policymakers alike.

Strategies to reduce excess weight and prevent the development of diabetes mellitus, hypertension and cardiovascular disease will reduce the risk of kidney disease.

About the Author

Dr. Csaba Kovesdy, Professor of Nephrology at University of Tennessee Health Science Center, Memphis, TN, US and Chief of Nephrology at the Memphis Veterans Affairs Medical Center. Dr. Kovesdy has joined the World Kidney Day Steering Committee for the 2017 edition of the campaign as expert on the association between kidney disease and obesity.  

World Kidney Day

World Kidney Day is the global awareness campaign that aims to spread the word about the importance of our kidneys to our overall health, and to reduce the frequency and impact of kidney disease and its associated health problems worldwide. Celebrated every year on the second Thursday of March, World Kidney Day has grown dramatically, to become the biggest event focused on kidney health around the world and the most successful effort to raise awareness both with the general public, medical professionals and government health officials about the dangers of kidney disease.