Obese children are often viewed as cute and huggable, but what parents may overlook is that obesity or being overweight can lead to numerous health risks. These risks may start with high blood pressure, which is six times more likely in overweight children compared to their peers. This can further lead to complications such as heart disease, stroke, kidney problems, or chronic kidney failure at an early age. Therefore, parents should pay attention to the appropriate weight standards for their children.

Kidney function and health care for the kidneys
The kidneys are small, bean-shaped organs that play a crucial role in filtering waste, excess fluid, and various minerals from the blood, which are then excreted as urine to maintain the body’s balance. These wastes result from metabolic processes and the functioning of different organs. If the kidneys are not functioning properly or if kidney failure occurs, waste and toxins can accumulate in the bloodstream. If not treated in a timely manner, this can lead to organ failure and even death.

Each year, there is an increasing number of new chronic kidney disease patients, with over 20,000 requiring dialysis. Currently, there are about 150,000 patients on dialysis. Kidney disease does not only occur due to age-related degeneration in the elderly; children and adolescents can also develop kidney issues due to various causes. One significant cause is the consumption of high-fat and high-sodium foods, along with obesity, being overweight, diabetes, and high blood pressure.

Why are obese children at risk for kidney disease?
In Thailand, around 1.4 million children are classified as obese or overweight out of a total child population of 17.6 million, which is approximately 8%. The primary reasons for obesity in Thai children include high-calorie foods, fried foods, sweets, and snacks, coupled with a sedentary lifestyle characterized by excessive smartphone use, computer gaming, or simply watching television.

Obesity is a factor that can lead to high blood pressure and increase the risk of diabetes and kidney disease. The kidneys of obese children often have to work harder than those of their normal-weight peers, which can lead to conditions like Focal Segmental Glomerulosclerosis, reducing the kidneys’ ability to filter waste.

High blood pressure and diabetes leading to kidney disease in obese children
It is well-known that non-communicable diseases (NCDs) such as kidney disease in adults are linked to high blood pressure and diabetes, which can also affect children. For instance:

- Diabetes: Obese children are at a higher risk of developing diabetes compared to their normal-weight peers. If high blood sugar levels are not managed, it can lead to diabetic kidney complications. Damage to the small blood vessels in the kidney glomerulus can impair waste filtration, potentially leading to chronic kidney disease or kidney failure.
Early diabetic kidney disease often presents no clear symptoms, but can be detected through the presence of protein (albumin) in urine, known as microalbuminuria, indicating abnormal kidney function. Therefore, controlling blood sugar levels is crucial to prevent and slow the progression of kidney disease.
- High blood pressure: If a child has high blood pressure, it can damage the blood vessels in the kidneys responsible for waste filtration. The glomerulus vessels may be subjected to higher-than-normal blood pressure for extended periods, leading to arteriosclerosis and narrowing of the vessels. This decreases blood flow to the kidneys, combined with reduced waste filtration efficiency, can result in chronic kidney disease and eventually kidney failure. Controlling blood pressure to acceptable levels is vital to minimize kidney damage, alongside lifestyle changes such as reducing salt intake, regular exercise, and managing related conditions.
 

Signs of kidney disease in children that parents should watch for
Warning signs of kidney disease in children that parents may observe include fatigue, paleness, weakness (which may indicate anemia), low weight, stunted growth, and noticeable swelling in areas like the face, eyelids, legs, or throughout the body due to fluid retention.

Reducing the risk of kidney disease in children through weight management and behavioral changes
To reduce the risk of kidney disease in children, parents should prioritize maintaining their child’s weight within the standard range. Being overweight or obese can adversely affect kidney health, increasing the risk of high blood pressure and diabetes compared to their peers.

Parents should encourage a balanced diet that aligns with appropriate caloric intake, particularly by reducing high-carbohydrate and high-fat foods, avoiding snacking, and promoting regular physical activity. Regular health check-ups are essential, and if a child is found to be overweight, it is important to consult a doctor to address weight loss without negatively impacting the child’s growth and health.