Background: Obesity increases the risk of many pathologies, including cardiovascular and renal diseases. This study aimed to determine the association between obesity and proteinuria as well as glomerular hemodynamic changes (an early marker of kidney damage) in obese children and its relationship with metabolic syndrome.Methods: This case-control study included 112 overweight and obese male and female patients aged 7 - 16 years, and 35 age- and gender-matched healthy controls. The obese patients were divided into 4 subgroups according to BMI: normal weight (control group), overweight, obese, morbidly obese. The glomerular filtration rate was estimated using classical and adjusted formulas based on the various body size descriptors of Leger, Schwartz, Filler, and Zappitelli, and chronic kidney disease formulas in all patients and controls. Creatinine, cystatin C, 24-hour urine protein, and the estimated glomerular filtration were compared between groups.Results: Blood pressure, creatinine, and 24-hour urine protein values were significantly higher in the overweight and obese patient subgroups (P<0.05). The estimated glomerular filtration rate, which was calculated using creatinine or cystatin C, was higher in the obese patients and subgroups than in the control group (P<0.05). In contrast, the estimated glomerular filtration rate measured using both classical and adjusted formulas was significantly lower in the obese patients than in the controls (P<0.05).Conclusions: Early indicators of renal damage are elevated urine protein and renal function test results compatible with impaired renal function. As such, obese pediatric patients should be routinely monitored for blood pressure, renal function, and proteinuria.

Introduction. Chronic Kidney Disease (CKD) is of high clinical importance due to cost of outcomes such as kidney transplantation. However, CKD is an overlooked disorder among commercial drivers. The present study aimed to evaluate hypertension and Glomerular Filtration Rate (GFR) among commercial drivers. Methods. In this cross-sectional study, a total of 903 commercial drivers referred for obtaining their health license were recruited. After obtaining informed consent, a questionnaire consisted of demographic characteristics was completed. Blood pressure, level of lipid profile, blood sugar, blood urea nitrogen, and plasma creatinine were measured. Chi-square and independent T-test were used for data analysis. Results. All participants were male. The mean ( ± SD) age and Body mass index were 42 ± (10) years and 27 ± (4) kg/m2, respectively. Of 903 studied cases 40 (4%) had GFR < 60. Increased age and high blood pressure had a significant association with reduced GFR (P <. 0001). The ones with sleep apnea were more likely to have GFR < 60, however, the association was not statistically significant after adjusting for related risk factors. Conclusion. Older age and hypertension are considered as risk factors for CKD among commercial drivers. Obstructive sleep apnea also should be kept in mind as a possible risk factor that requires further elucidation and management.

Background and Aims: Overweight and obesity are significant risk factors for chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best index of renal function. We evaluated the accuracy of the Cockroft-Gault, MDRD and modified MDRD formulae in predicting GFR in overweight and obese subjects and also determined the relationship between Body Mass Index (BMI), weight and GFR.Methods: Healthy volunteers with BMI ³23kg/m² were recruited and subjected to blood and urine investigations, renal ultrasonography and 99mTc-DTPA renal scan. The correlation, accuracy and precision of the eGFR derived from each formula were compared with reference GFR as determined by 99mTc-DTPA. Results: A total of 101 subjects with a median weight of 74.0kg (68.0-84.7) and median BMI of 29.6 kg/m2 (27.2-33.2) were recruited. Their mean GFR 99mTc-DTPA was 120.3± 24.5ml/mm/1.73m². Although the eGFRs derived from all formulae correlated with GFR 99mTc-DTPA, only those derived from the MDRD and modified MDRD had small biases and better precision in estimating GFR. While GFR significantly correlated with the subjects’ weight (p=0.036), it didn’t with their BMI (p=0.302).Conclusions: The MDRD-based formulae were better in estimating GFR in overweight and obese Malaysian subjects. GFR correlated with subjects’ weight rather than BMI.