Glomerular hyperfiltration in excess weight adolescents.

BACKGROUND: Childhood overweight/obesity burden is on the rise worldwide. Obesity affects virtually all organs. In the kidney, glomerular hyperfiltration that manifests as elevated glomerular filtration rate is a frequent manifestation in obesity. This adaptive renal manifestation to excess metabolic demand on the kidney, in children, has been studied mainly in the severely obese and is uncertain if it is present in less severe forms of excessive weight. In addition, glomerular hyperfiltration has been reported to be associated with high levels of the indicators of cardiometabolic risk, and these latter finding are solely from adult studies. OBJECTIVE: To ascertain if glomerular hyperfiltration occurs in overweight and less severely obese children and to determine any significant relevance of some indicators of cardiometabolic risk associated with hyperfiltration. SUBJECTS AND METHODS: This cross-sectional study involved 49 adolescents (28 overweight, 21 obese) and 49 normal weight adolescents. The participants were subjected to clinical examination, anthropometric measurement, laboratory investigation using standard techniques. Estimated glomerular filtration rates (eGFR) were calculated using the modified Schwartz equation. Hyperfiltration was defined as eGFR ≥140 ml/min/1.73 m2. RESULTS: Hyperfiltration was observed in 20 (40.8%) of the overweight/obese adolescents. The prevalence of hyperfiltration among the overweight and the obese adolescent was 24.5% and 16.3%, respectively. The mean estimated glomerular filtration rate of the overweight/obese adolescents was 141.0 ± 46.2 ml/min/1.73 m2, whereas that of the normal weight adolescents was 99.2 ± 17.1 ml/min/1.73 m2 (P = 0.0001). A higher prevalence of hypertension was observed among the overweight/obese adolescent with glomerular hyperfiltration. CONCLUSION: Glomerular hyperfiltration is not limited to morbidly obese children as the burden is also high in overweight and less severely obese adolescents.

Effects of chemotherapy on plasma lipids and lipoproteins in Nigerian patients with haematological malignancy.

AIMS AND OBJECTIVES: This study is to determine effect of chemotherapy on plasma lipids and lipoproteins in haematological malignancies. PATIENTS AND METHODS: All consecutive patients with haematological malignancies attending University of Benin Teaching Hospital, Benin City, Nigeria between July 2007 and December 2008 were studied. Clinico-pathological types of haematological cancers, demographic features, serum lipid and lipoprotein levels of the patients were analysed, pre and post treatment with chemotherapy. RESULTS: A total of 28 haematological cancers were studied. Chronic leukemias 10 (35.7%) and lymphomas 7(25.0%),acute leukaemia 6(21.4%), multiple myeloma 4(14.3%), and aplastic anaemia 1(3.6%). The pre therapy median values for TC, TG, LDL-C and HDL-C were 103, 115, 40 and 36mg/dl respectively while the median values for post therapy for TC, TG, LDL-C and HDL-C were 110, 126, 60 and 43 mg/dl respectively. The pre therapy ratio of TC : HDL-C in the patients was 2.4 while the post therapy ratio of TC : HDL-C was 2.7. CONCLUSION: Hypocholesterolaemia and hypolipoproteinaemia were seen in our patients when compared with the population reference values and there were no significant changes in lipid and lipoprotein levels between pre and post therapy values.