Overweight and obese young adults are at elevated risk for declines in renal function, according to a study.

Researchers led by Vanessa Grubbs, MD, MPH, of the University of California San Francisco, studied 2,839 participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who had preserved renal function at baseline (estimated glomerular filtration rate [eGFR] above 90 mL/min/1.73 m2 as measured using cystatin C levels). These subjects were among 5,115 asymptomatic individuals aged 18-30 years recruited from 1985-1986 and who took part in a 10-year follow-up examination in 1995-1996. At baseline, patients had a mean age of 35 years and 24.5% were obese.

After age 30 years, the average eGFR declined progressively with each increment in BMI, after adjusting for baseline age, race, gender, hyperlipidemia, smoking status, and physical activity.

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Compared with participants who had a BMI of 18.5-24.9 kg/m2 at baseline, those with a BMI of 25.0-25.9 (overweight), 30.0-39.9 (obese), and 40 or above (extremely obese) at baseline had a 1.5, 2.0, and 2.6 times increased odds of a rapid eGFR decline (greater than 3% per year), respectively, researchers reported online ahead of print in the American Journal of Kidney Diseases.

“Given the growing epidemic of obesity in adults and children, the long-term impact of these findings could be substantial,” the authors concluded. “Clinicians should vigilantly monitor overweight and obese patients for evidence of early kidney function decline.”