Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study explores risks of obesity in children with kidney transplants

07.02.2005


Obese children who get kidney transplants tend to be younger, shorter and on dialysis longer than their leaner peers, according to a study in the February issue of the journal Pediatrics.

A review of 6,658 children age 2-17 receiving transplants in the United States, Mexico and Canada between 1987 and 2002 showed that obese children age 6-12 had a five-year mortality rate more than double that of non-obese children the same age: 12.1 percent compared to 5.4 percent respectively.

Across the entire age spectrum studied, obese children who received a transplant were more likely to die of cardiopulmonary disease – the leading cause of death in adult kidney transplant patients – than non-obese children. "Pediatricians should educate families on the potential risks of excessive weight gain during dialysis and post-kidney transplant," the authors write, noting that obesity is an increasing problem in patients of all ages with end-stage renal disease and one that has received little attention in children.



"These are going to be prematurely old children in a way because they are going to have all these cardiovascular complications and risks at a younger age," says Dr. Coral D. Hanevold, lead author and chief of the Section of (Pediatric) Nephrology at the Medical College of Georgia in Augusta. "These children are more likely to develop hypertension, hyperlipidemia and diabetes at an early age. We are doing transplants so these children can survive, but if they are overweight, that is going to cut into their life expectancy."

She notes that while most children with kidney failure are not overweight, the numbers are increasing: 8 percent of the study children were categorized as obese between 1987-1995 compared with 12.4 percent between 1995-2002. "Obesity is an increasing problem in children presenting for transplantation and may have an adverse effect on allograft and patient survival," the authors write. Some transplant centers are not performing transplants on extremely obese children because of those concerns. Also, obesity-related kidney disease, which occurs in extremely obese adults, is beginning to be seen in children.

The retrospective study of the North American Pediatric Renal Transplant Cooperative Study was done in conjunction with Dr. Mark M. Mitsnefes, Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center in Ohio and The EMMES Corporation, a Rockville, Md.-based company that provides operational support for clinical and biomedical research.

Researchers found obese children generally got their transplants at an earlier age, 8.9 years versus 11 years; spent more time on dialysis than their leaner peers and were more frequent users of peritoneal dialysis, which takes place within the body. With peritoneal dialysis, patients put a sugar-rich sterile solution called dialysate into their abdominal cavity through a catheter. The dialysate pulls waste and excess fluid from the blood, which is drained from the abdomen. Although some say this approach is more natural than hemodialysis, where patients spend several hours typically three days a week hooked up to a machine that removes their blood, cleans it and returns it to them, the sugar-rich dialysate provides a lot of calories and can help contribute to obesity, Dr. Hanevold says.

Children who develop kidney failure at a young age have difficulty gaining height and weight and, ironically, nutritional supplements some children are given to help them grow normally may contribute to obesity as well, she says. "If you don’t get renal failure until you are older, then you usually grow to be a pretty good size before kidney failure started making it hard for you to grow tall," she says. "In the young children, we provide a lot of nutritional support, hoping to ensure normal growth, but sometimes they grow more out than up."
Perhaps even more ironically, some of the drugs required to avoid rejecting a transplanted kidney also can contribute to obesity and other problems, Dr. Hanevold says. Prednisone, a non-specific immunosuppressive agent, typically given in conjunction with newer, more potent and specific agents such as cyclosporine, can make children ravenous, she says. Other possible side effects such as high blood pressure and diabetes contribute to concerns about the cardiovascular health of these children.

Studies are under way to try and reduce or eliminate prednisone, although results to date indicate children might have to take quite a bit more of the other immunosuppressive agents instead, which have their own side effects, Dr. Hanevold says.

To help minimize risks, she suggests parents and pediatricians make good nutrition a part of the ongoing care of children with kidney disease – and all children.

"Adolescents may already be overweight when they develop kidney disease and the little ones may develop obesity as a result of some of their therapy," she says. "We need to try and help kids, if they are heavy, to try to lose weight before they get a transplant and to pay more attention to their weight afterward."

Toni Baker | EurekAlert!
Further information:
http://www.mcg.edu

More articles from Studies and Analyses:

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

nachricht Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>