PREVALENCE AND FACTORS ASSOCIATED WITH ALBUMINURIA IN OVERWEIGHT AND OBESE SECONDARY SCHOOL STUDENTS IN SURULERE LOCAL GOVERNMENT AREA OF LAGOS STATE

Abstract

A significant increase in the prevalence of chronic kidney disease (CKD) and end stage kidney
disease (ESKD) have been reported in the last decade in tandem with the epidemic of obesity in
the general population. Specifically, a higher body mass index (BMI) has emerged as a strong
independent predictor of CKD and ESKD using albuminuria as a surrogate marker. Evidence
abounds regarding the influence of obesity on the kidneys in adults. However, little is known
about the association of obesity with kidney damage in children. The study was designed with
the main objective of determining the prevalence of albuminuria in overweight and obese
children and identifying the relationship between albuminuria and sociodemographic factors and
other factors such as hypertension and central obesity.
The study was a cross-sectional comparative study involving overweight and obese children and
age and sex matched normal weight controls chosen via multistaged random sampling from eight
secondary schools in Surulere Local Government Area of Lagos State. It was carried out
between April and July 2016. Relevant sociodemographic data (age, sex, socioeconomic status)
was obtained from each participant by interview followed by a physical examination which
focused on blood pressure and anthropometric measurements. Each child provided a freshly
voided urine sample which was stored in a cool box until refrigeration in the laboratory. Albumin
was determined using immunoturbidimetry and urine creatinine using the Jaffe rate reaction
method. Albuminuria was defined as urine albumin-creatinine ratio of ≥30 mg/g.
Two hundred and eighty five children were included in the analyses (93 obese, 95 overweight
and 97 children with normal BMI). The mean age of the study participants was 14.5±1.8 years
and 14.8% were males. The prevalence of albuminuria among overweight and obese subjects
was 20.4% and 24.2% respectively. This was similar to the albuminuria prevalence rate of
24.7% in the controls (p=0.65). Obesity was strongly associated with hypertension in both sexes.
Overweight and obese females had significantly higher median urine albumin-creatinine ratio
compared with overweight and obese males. There were no statistically significant associations
between albuminuria and hypertension, age, sex, and waist circumference in the obese and
overweight subjects.
The findings from this study did not support the hypothesis of increased albuminuria in
overweight and obese children in our environment. It however adds to the existing evidence of
increased prevalence of comordities (hypertension) in the overweight and obese.

PREVALENCE AND FACTORS ASSOCIATED WITH ALBUMINURIA IN OVERWEIGHT AND OBESE SECONDARY SCHOOL STUDENTS IN SURULERE LOCAL GOVERNMENT AREA OF LAGOS STATE