ORIGINAL ARTICLE

Blood pressure and glomerular filtration rate in obese adolescents

Gusti Ayu Putu Sri Satya Mahayani, I Made Arimbawa , Ida Bagus Subanada, I Wayan Dharma Artana, I Nyoman Budi Hartawan, I Ketut Suarta

Gusti Ayu Putu Sri Satya Mahayani
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia

I Made Arimbawa
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia. Email: maderimawa@gmail.com

Ida Bagus Subanada
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia

I Wayan Dharma Artana
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia

I Nyoman Budi Hartawan
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia

I Ketut Suarta
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia
Online First: December 01, 2021 | Cite this Article
Mahayani, G., Arimbawa, I., Subanada, I., Artana, I., Hartawan, I., Suarta, I. 2021. Blood pressure and glomerular filtration rate in obese adolescents. Bali Medical Journal 9(3): 844-848. DOI:10.15562/bmj.v9i3.2061


Background: Obesity in children has the potential to increase the risk of morbidity and even death in the future. One of the diseases that are at risk due to obesity is hypertension and also impaired kidney function. Glomerular filtration rate differences in obese and normal-weight children are somehow contradictory. This study aims to prove the difference in blood pressure and kidney function in adolescents with obese and non-obese.

Methods: A cross-sectional study was conducted among high school children in Denpasar. Subjects were classified as obese and non-obese. The Mann-Whitney test was used to assess the mean difference of blood pressure, whereas the Independent t-test was used to determine the mean difference of GFR. Multivariate analysis was performed with logistic regression and ANCOVA. Data were analyzed using SPSS version 20 for Windows.

Results: A total of 68 subjects with obese and 52 subjects with non-obese were included in this study. Systolic and diastolic blood pressure in the obese group was higher than in a non-obese group, with the mean difference in systolic and diastolic blood pressure was 29 mmHg (P<0.001) and 18 mmHg (P=0.002), respectively. Obesity increases the risk of hypertension 9.78 times (95% CI: 1.86-51.39; P=0.007), and obese adolescents have an average GFR of 11.51 lower than non-obese (95% CI: 17.32 – (-5.69); P<0.001).

Conclusion: Hypertension is higher in obese adolescents than non-obese, while glomerular filtration rate is lower than non-obese adolescents.

References

Kumar P, Kumar D, Ranjan A, Singh CM, Pandey S, Agarwal N. Prevalence of Hypertension and its Risk Factors Among School Going Adolescents of Patna, India. J Clin Diagn Res. 2017;11(1):SC01-SC04.

Gauer R, Belprez M, Rerucha C. Pediatric hypertension: often missed and mismanaged. J Fam Pract. 2014;63(3):129-136.

Duzova A, Yalçinkaya F, Baskin E, Bakkaloglu A, Soylemezoglu O. Prevalence of hypertension and decreased glomerular filtration rate in obese children: results of a population-based field study. Nephrol Dial Transplant. 2013;28 Suppl 4:iv166-iv171.

Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113(3 Pt 1):475-482.

Badeli H, Hassankhani A, Naeemi Z, Hosseinzadeh S, Mehrabi S, Pourkarimi M, et al. Prevalence of Hypertension and Obesity-related Hypertension in Urban School-aged Children in Rasht. Iran J Kidney Dis. 2016;10(6):364-368.

Ziegler EE. The CDC and Euro Growth Charts. World Rev Nutr Diet. 2015;113:295-307.

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555-576.

Schwartz GJ, Furth SL. Glomerular filtration rate measurement and estimation in chronic kidney disease. Pediatr Nephrol. 2007;22(11):1839-1848.

Pranata S, Fauziah Y, Budisuari MA, Kusrini I. Status Gizi. Riset Kesehatan Dasar dalam Angka Provinsi Bali. Jakarta: Lembaga Penerbitan Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. 2013, p.248-75.

Malik M, Bakir A. Prevalence of overweight and obesity among children in the United Arab Emirates. Obes Rev. 2007;8(1):15-20.

Rutkowski B, Czarniak P, Król E, Szcześniak P, Zdrojewski T. Overweight, obesity, hypertension and albuminuria in Polish adolescents--results of the Sopkard 15 study. Nephrol Dial Transplant. 2013;28 Suppl 4:iv204-iv211.

Adrogué HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2007;356(19):1966-1978.

Chen S. Essential hypertension: perspectives and future directions. J Hypertens. 2012;30(1):42-45.

Feld LG, Corey H. Hypertension in childhood. Pediatr Rev. 2007;28(8):283-298.

Rosner B, Cook N, Portman R, Daniels S, Falkner B. Blood pressure differences by ethnic group among United States children and adolescents. Hypertension. 2009;54(3):502-508.

Kembuan IY, Kandou G, Kaunang WPJ. Hubungan obesitas dengan penyakit hipertensi pada pasien poliklinik Puskesmas Touluaan Kabupaten Minahasa Tenggara. Paradigma. 2016;4(2):16-35.

Tounian P, Aggoun Y, Dubern B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001;358(9291):1400-1404.

Mohammed H, Ghosh S, Vuvor F, Mensah-Armah S, Steiner-Asiedu M. Dietary intake and the dynamics of stress, hypertension and obesity in a peri-urban community in Accra. Ghana Med J. 2016;50(1):16-21.

Appel LJ, Frohlich ED, Hall JE, Pearson TA, Sacco RL, Seals DR, et al. The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke: a call to action from the American Heart Association. Circulation. 2011;123(10):1138-1143.

Koulouridis E, Georgalidis K, Kostimpa I, Koulouridis I, Krokida A, Houliara D. Metabolic syndrome risk factors and estimated glomerular filtration rate among children and adolescents. Pediatr Nephrol. 2010;25(3):491-498.

Goknar N, Oktem F, Ozgen IT, Torun E< Kucukkoc M, Demir AD, et al. Determination of early urinary renal injury markers in obese children. Pediatr Nephrol. 2015;30(1):139-144.

Cindik N, Baskin E, Agras PI, Kinik ST, Turan M, Saatci U. Effect of obesity on inflammatory markers and renal functions. Acta Paediatr. 2005;94(12):1732-1737.

Fenton A, Montgomery E, Nightingale P, Peters AM, Sheerin N, Wroe AC, et al. Glomerular filtration rate: new age- and gender- specific reference ranges and thresholds for living kidney donation. BMC Nephrol. 2018;19(1):336.

Santos EMD, Brito DJA, França AKDCT, Lages JS, Santos AMD, Salgado Filho N. Association between estimated glomerular filtration rate and sodium excretion in urine of African descendants in Brazil: a population-based study. J Bras Nefrol. 2018;40(3):248-255.

Pertiwi GAR, Aryawangsa AAN, Prabawa IPY, Manuaba IBAP, Bhargah A, Ratni NWS, et al. Factors associated with visit-to-visit variability of blood pressure in hypertensive patients at a Primary Health Care Service, Tabanan, Bali, Indonesia. Family Medicine and Community Health. 2018;6(4):191-199.

Bhargah A, Muliarta M, Prabawa IPY, Manuaba IBAP, Bhargah V. Post-Exercise Hypotension Phenomenon in Elderly after Aerobic Exercise. Journal of Global Pharma Technology. 2018;10(6):323-327


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