Early Cardiometabolic Risk and Vascular Injury - Impact on the Kidney

Alberto Caldas Afonso

Coordinator:

Integrated Member (PhD)
This laboratory focuses on the study of the impact of obesity on vascular health and on the kidneys of young children, while also intending to clarify some of the potential mechanisms involved. The group aims to improve the understanding of the long-term impacts of excessive weight throughout life.  

Obesity is a Public Health problem that begins early in life and accompanies the child throughout the life course. In parallel, the incidence of type 1 diabetes (T1D) among the pediatric population is increasing. Evidence suggests that obesity increases the risk of renal disease and diabetic kidney disease remains the leading cause of end-stage renal disease worldwide. The injury causal mechanisms involved in these settings remain not yet fully understood in children and adolescents. Some of the deleterious pathways include renal hemodynamic changes, a process of relative ischemia associated with oxidative stress, a proinflammatory milieu and an overactive renin-angiotensin-aldosterone system.

The lab intends to study the evolution of cardiometabolic, vascular and kidney function changes associated with obesity and with T1D, by determining several biomarkers and analyzing their trend, from childhood to adolescence.

In future research, the aim is to compare overweight/obese, normal weight and T1D patients at two different ages, with the intention of: 

  1. Investigating changes in various renal function indexes/markers, both of glomerular and tubular function; 
  2. Quantifying specific urinary and blood biomarkers of renal damage, inflammation, adipose tissue dysfunction, redox and total antioxidant status and endothelial dysfunction, and evaluate their impact on kidney function; 
  3. Characterizing the systemic and intrarenal RAAS activity and evaluate its impact on kidney function; 
  4. Performing a cardiovascular evaluation by assessing office blood pressure, 24-hour ambulatory monitoring of blood pressure, arterial and endothelial function using several methods of arterial stiffness estimation, and cardiovascular reflexes, and analyze the impact of these markers on the kidney.

Overall, the group intends to continue to contribute to the understanding of the impact of obesity on young kidneys and vasculature. The recognition of inflammation and oxidative stress as detrimental factors for the cardiovascular health and for renal function at such young ages should make clinicians aware of the importance of implementing early strategies to prevent and fight childhood obesity. 

Research Lab Team

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