High blood pressure in kidneys possible explanation for renal disease in people with apple-shaped bodies

People with an apple-shaped body have a higher risk of developing renal disease. Little is known about the underlying mechanism, but a recent study carried out by medical researcher Arjan Kwakernaak from the University Medical Center Groningen shows that these people often have raised blood pressure in their kidneys. This may explain why people with an apple-shaped body have a higher risk of developing renal disease. The research is published in the Journal of American Society of Nephrology (JASN).

It is a well-known fact that people with an apple-shaped body, i.e. with fat concentrated around the abdomen, have higher risk of developing renal disease in later life. However, the underlying mechanism is unclear. Arjan Kwakernaak and his colleagues explored the link between the ratio between waist and hip circumference (as a measure of fat distribution), and the blood pressure in the kidneys. They tested 315 healthy people. The research showed that people with an apple-shaped body have higher blood pressure, and also lower blood circulation in their kidneys, and lower kidney function. Kwakernaak: ‘We have discovered that people with an apple-shaped body have raised blood pressure in their kidneys, even if they are completely healthy and have normal arterial blood pressure. We found this effect even in people with a normal body weight, but it is more pronounced in people who are overweight or obese.’

The research suggests that high blood pressure in the kidneys may be one of the factors that cause apple-shaped people to develop renal disease in later life. Previous studies have shown that high blood pressure in the kidneys can be treated by reducing salt intake or administering medication that blocks what is known as the renin-angiotensin-aldosterone system (RAAS). The RAAS regulates the blood flow through the kidneys, and therefore the blood pressure in the kidneys. Blocking the system can reduce the blood pressure in the kidneys. ‘We need more research to find out whether people with an apple-shaped body will benefit from targeted treatment to lower the blood pressure in the kidneys’, says Kwakernaak.