In 2017, the theme of the World Kidney Day is ‘Obesity and Kidney Disease - Healthy Lifestyle and Healthy Kidneys’. Since 2015, I have written several articles during the month of March, highlighting the link between obesity and Kidney disease. I have also discussed several preventive steps that could be taken to avoid Chronic Kidney Disease (CKD) and subsequent dialysis. CKD, one of the fastest growing chronic non-communicable diseases (NCD) in last two decades, is now the 13th leading cause of death worldwide, killing more than a million people annually. It has become one of the top reasons for deaths even in several developing countries.
We are in the midst of obesity pandemic. The International Obesity Task Force estimates about 2 billion adults, i.e., one third of the global population are overweight. Obesity, associated with NCDs such as diabetes mellitus (DM), hypertension(HTN), cardiovascular disease and cancer, results in higher morbidity, disability, premature deaths and financial burden. CKD is most commonly caused by DM and HTN, two conditions associated with obesity. The more direct effects on the kidney result from substances secreted from the fat tissue known as adipokines. These substances result in structural changes known as obesity related glomerulopathy. Thus obesity, directly or indirectly through DM and HTN, should be considered the most important risk factor for CKD.
Apart from CKD, obesity also is a risk factor for increased protein leak in urine, kidney stones and cancers of the kidney. The detrimental effects of obesity on renal transplantation are also being increasingly recognized.
Several studies worldwide are showing the beneficial effects of weight reduction and increased physical activity on slowing the progression of CKD. Low cost alternatives through preventive strategies instead of expensive therapies are very much needed, particularly in developing countries with limited resources. Encouraged by understanding of this preventable link, the author has started “STOP KIDNEY DISEASE” initiative. The mission is to prevent CKD and end stage kidney disease through modification of lifestyle risk factors.
The National Kidney Month and World Kidney Day serve to remind us of the importance of prevention to decrease the burden of kidney disease. To take this knowledge to the community, some of the steps that the STOP KIDNEY DISEASE initiative has in last few months are:
Alok Agrawal, MD, FASN, FNKF
Founder, Global Pragathi (Non-Profit Organization)
Nephrologist, VA Hospital, Dayton, Ohio