World Kidney Day: Obesity and kidney disease

Dr Sanjeeev Gulati *

Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country’s population.

Not only that according to a recent WHO report Childhood obesity is reaching alarming proportions with India reporting around 22% prevalence rate over the last 5 years in children and adolescents aged between 5-19 years.

India is following a trend of other developing countries that are steadily becoming more obese. A study published in Lancet shows that India is the third most obese country in the world behind USA and China.

The reasons for this are multifold. There is rising middle class income which is increasing the average caloric intake per individual among the middle class and above income household. People are spending longer hours at workplace. Coupled with this is the traditional lack of any fitness routine in majority of the people of our country.

Fast foods like pizzaas and burgers and other commercial beverages which are unhealthy have become much more accessible following globalization. People across all socioeconomic classess are incersingly getting addicted to these foods and beverages.

Thus India is uder siege and this unholy triad of junk foods, alcohol and other beverages and a sedentary lifestyle is leading us to silent self-destruction and one in every five Indians is becoming onese or overweight .

In 2014, over 600 million adults worldwide, 18 years and older, were obese. There were 20 million obese women in India in 2014 compared with 9.8 million obese men, according to a study published in the British medical journal, the Lancet.

Severe obesity was observed in an additional 4 million Indian women. There were less than 800,000 obese women in India in 1975 compared with 400,000 obese men. There is an increasing prevalence of obesity even in school children .

This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for Chronic Kidney Disease (CKD).

In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing CKD in the long-term.

The incidence of obesity-related glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer.

This year the “World Kidney Day” promotes education on the harmful consequences of obesity and its association with kidney disease advocating healthy lifestyle. There should be educational initiatives at the school level itself on the harmful consequences of obesity.

Children should be encouraged to spend more time outdoors than on computers and mobiles. School canteens should be bared from serving junk food and beverages. We should incorporate a fitness regime in our work schedule , revert back to our traditional and healthy food options.

The government needs to incorporate health policy measures that make preventive behaviors an affordable option and the institutions of world Yoga day is a welcome step in this direction. An annual health screening for Kidney disease should be done in all obese and overweight people to pick up kidney disease early and institute appropriate therapeutic interventions.