PDF herunterladen
Horm Metab Res 2018; 50(07): 556-561
DOI: 10.1055/a-0599-6360
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Increasing Body Mass Index Predicts Rapid Decline in Renal Function: A 5 Year Retrospective Study

Xiaojing Ma
1   Department of Health Examination Center, Qianfoshan Hospital, Shandong University, Jinan, China
,
Chengyin Zhang
2   Department of Nephrology, Yidu Central Hospital, Weifang Medical College, Qingzhou, China
,
Hong Su
3   Qilu Medical college, Shandong University, Jinan, China
,
Xiaojie Gong
3   Qilu Medical college, Shandong University, Jinan, China
,
Xianglei Kong
4   Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China
› Institutsangaben
Weitere Informationen

Publikationsverlauf



accepted 26. März 2018

Publikationsdatum:
02. Mai 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

While obesity is a recognized risk factor for chronic kidney disease, it remains unclear whether change in body mass index (ΔBMI ) is independently associated with decline in renal function (evaluated by the change in estimated glomerular filtration rate, ΔeGFR) over time. Accordingly, to help clarify this we conducted a retrospective study to measure the association of ΔBMI with decline in renal function in Chinese adult population. A total of 4007 adults (aged 45.3±13.7 years, 68.6% male) without chronic kidney disease at baseline were enrolled between 2008 and 2013. Logistic regression models were applied to explore the relationships between baseline BMI and ΔBMI, and rapid decline in renal function (defined as the lowest quartile of ΔeGFR ). During 5 years of follow-up, the ΔBMI and ΔeGFR were 0.47±1.6 (kg/m2) and –3.0±8.8 (ml/min/1.73 m2), respectively. After adjusted for potential confounders, ΔBMI (per 1 kg/m2 increase) was independently associated with the rapid decline in renal function [with a fully adjusted OR of 1.12 (95% CI, 1.05 to 1.20). By contrast, the baseline BMI was not associated with rapid decline in renal function [OR=1.05 (95% CI, 0.98 to 1.13)]. The results were robust among 2948 hypertension-free and diabetes-free participants, the adjusted ORs of ΔBMI and baseline BMI were 1.14 (95% CI, 1.05 to 1.23) and 1.0 (95% CI, 0.96 to 1.04) for rapid decline in renal function, respectively. The study revealed that increasing ΔBMI predicts rapid decline in renal function.

Key words

body mass index - renal function - proteinuria - estimated glomerular filtration rate - epidemiology
 

  • References

  • 1 Ng M, Fleming T, Robinson M. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384: 766-781
    Suche in Google Scholar
  • 2 Ji CY, Cheng TO. Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005. Int J Cardiol 2009; 132: 1-10
    CrossrefPubMedSuche in Google Scholar
  • 3 Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, Danaei G. Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects) . Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: A pooled analysis of 97 prospective cohorts with 1.8 million participants. Lancet 2014; 383: 970-983
    CrossrefPubMedSuche in Google Scholar
  • 4 Jensen MD, Kanaley JA, Reed JE, Sheedy PF. Measurement of abdominal and visceral fat with computed tomography and dual-energy x-ray absorptiometry. Am J Clin Nutr 1995; 61: 274-278
    CrossrefPubMedSuche in Google Scholar
  • 5 Madero M, Katz R, Murphy R, Newman A, Patel K, Ix J, Peralta C, Satterfield S, Fried L, Shlipak M, Sarnak M. Comparison between different measures of body fat with kidney function decline and incident CKD. Clin J Am Soc Nephrol 2017; 12: 893-903
    CrossrefPubMedSuche in Google Scholar
  • 6 Garofalo C, Borrelli S, Minutolo R, Chiodini P, De Nicola L, Conte G. Systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population. Kidney Int 2017; 91: 1224-1235
    CrossrefPubMedSuche in Google Scholar
  • 7 Li Y, Qin X, Xie D, Tang G, Xing H, Li Z, Xu X, Hou F, Xu X. Body mass index and annual estimated GFR decline in Chinese adults with normal renal function. Eur J Clin Nutr 2015; 69: 922-926
    CrossrefPubMedSuche in Google Scholar
  • 8 Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985; 33: 278-285
    CrossrefPubMedSuche in Google Scholar
  • 9 National Kidney F . K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002; 39: S1-S266
    PubMedSuche in Google Scholar
  • 10 Chen XN, Pan XX, Yu HJ, Shen PY, Zhang QY, Zhang W, Ren H, Qian Y, Zhu P, Chen N. Analysis of cardiovascular disease in Chinese inpatients with chronic kidney disease. Intern Med 2011; 50: 1797-1801
    CrossrefPubMedSuche in Google Scholar
  • 11 De Leeuw PW, Thijs L, Birkenhager WH, Voyaki SM, Efstratopoulos AD, Fagard RH, Leonetti G, Nachev C, Petrie JC, Rodicio JL, Rosenfeld JJ, Sarti C, Staessen JA. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators . Prognostic significance of renal function in elderly patients with isolated systolic hypertension: Results from the Syst-Eur trial. J Am Soc Nephrol 2002; 13: 2213-2222
    CrossrefPubMedSuche in Google Scholar
  • 12 Ohishi M, Tatara Y, Ito N, Takeya Y, Onishi M, Maekawa Y, Kato N, Kamide K, Rakugi H. The combination of chronic kidney disease and increased arterial stiffness is a predictor for stroke and cardiovascular disease in hypertensive patients. Hypertens Res 2011; 34: 1209-1215
    CrossrefPubMedSuche in Google Scholar
  • 13 Muntner P, He J, Hamm L, Loria C, Whelton PK. Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States. J Am Soc Nephrol 2002; 13: 745-753
    PubMedSuche in Google Scholar
  • 14 Rifkin DE, Shlipak MG, Katz R, Fried LF, Siscovick D, Chonchol M, Newman AB, Sarnak MJ. Rapid kidney function decline and mortality risk in older adults. Arch Intern Med 2008; 168: 2212-2218
    CrossrefPubMedSuche in Google Scholar
  • 15 Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J. Blood pressure and end-stage renal disease in men. N Engl J Med 1996; 334: 13-18
    CrossrefPubMedSuche in Google Scholar
  • 16 Silverwood RJ, Pierce M, Thomas C, Hardy R, Ferro C, Sattar N, Whincup P, Savage C, Kuh D, Nitsch D. National Survey of Health and Development Scientific and Data Collection Teams . Association between younger age when first overweight and increased risk for CKD. J Am Soc Nephrol 2013; 24: 813-821
    CrossrefPubMedSuche in Google Scholar
  • 17 Nagel G, Zitt E, Peter R, Pompella A, Concin H, Lhotta K. Body mass index and metabolic factors predict glomerular filtration rate and albuminuria over 20 years in a high-risk population. BMC Nephrol 2013; 14: 177
    CrossrefPubMedSuche in Google Scholar
  • 18 Grubbs V, Lin F, Vittinghoff E, Shlipak MG, Peralta CA, Bansal N, Jacobs DR, Siscovick DS, Lewis CE, Bibbins-Domingo K. Body mass index and early kidney function decline in young adults: A longitudinal analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) study. Am J Kidney Dis 2014; 63: 590-597
    CrossrefPubMedSuche in Google Scholar
  • 19 Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro 3rd AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J. CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) . A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-612
    CrossrefPubMedSuche in Google Scholar
  • 20 Kong X, Ma Y, Chen J, Luo Q, Yu X, Li Y, Xu J, Huang S, Wang L, Huang W, Wang M, Xu G, Zhang L, Zuo L, Wang H. Chinese eGFR Investigation Collaboration . Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating glomerular filtration rate in the Chinese population. Nephrol Dial Transplant 2013; 28: 641-651
    CrossrefPubMedSuche in Google Scholar
  • 21 Ryu S, Chang Y, Woo HY, Kim SG, Kim DI, Kim WS, Suh BS, Choi NK, Lee JT. Changes in body weight predict CKD in healthy men. J Am Soc Nephrol 2008; 19: 1798-1805
    CrossrefPubMedSuche in Google Scholar
  • 22 Bello AK, de Zeeuw D, El Nahas M, Brantsma AH, Bakker SJ, de Jong PE, Gansevoort RT. Impact of weight change on albuminuria in the general population. Nephrol Dial Transplant 2007; 22: 1619-1627
    CrossrefPubMedSuche in Google Scholar
  • 23 Lu JL, Molnar MZ, Naseer A, Mikkelsen MK, Kalantar-Zadeh K, Kovesdy CP. Association of age and BMI with kidney function and mortality: A cohort study. Lancet Diabetes Endocrinol 2015; 3: 704-714
    CrossrefPubMedSuche in Google Scholar
  • 24 Kambham N, Markowitz GS, Valeri AM, Lin J, D'Agati VD. Obesity-related glomerulopathy: An emerging epidemic. Kidney Int 2001; 59: 1498-1509
    CrossrefPubMedSuche in Google Scholar
  • 25 Praga M, Hernandez E, Morales E, Campos AP, Valero MA, Martinez MA, León M. Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant 2001; 16: 1790-1798
    CrossrefPubMedSuche in Google Scholar
  • 26 Wahba IM, Mak RH. Obesity and obesity-initiated metabolic syndrome: Mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol 2007; 2: 550-562
    CrossrefPubMedSuche in Google Scholar
  • 27 Mathew AV, Okada S, Sharma K. Obesity related kidney disease. Curr Diabetes Rev 2011; 7: 41-49
    CrossrefPubMedSuche in Google Scholar
  • 28 Mauras N, Delgiorno C, Kollman C, Bird K, Morgan M, Sweeten S, Balagopal P, Damaso L. Obesity without established comorbidities of the metabolic syndrome is associated with a proinflammatory and prothrombotic state, even before the onset of puberty in children. J Clin Endocrinol Metab 2010; 95: 1060-1068
    CrossrefPubMedSuche in Google Scholar
  • 29 Codoner-Franch P, Boix-Garcia L, Simo-Jorda R, Del Castillo-Villaescusa C, Maset-Maldonado J, Valls-Bellés V. Is obesity associated with oxidative stress in children?. Int J Pediatr Obes 2010; 5: 56-63
    CrossrefPubMedSuche in Google Scholar
  • 30 Prunotto M, Ghiggeri G, Bruschi M, Gabbiani G, Lescuyer P, Hocher B, Chaykovska L, Berrera M, Moll S. Renal fibrosis and proteomics: Current knowledge and still key open questions for proteomic investigation. J Proteomics 2011; 74: 1855-1870
    CrossrefPubMedSuche in Google Scholar
  • 31 Kalaitzidis RG, Siamopoulos KC. The role of obesity in kidney disease: Recent findings and potential mechanisms. Int Urol Nephrol 2011; 43: 771-784
    CrossrefPubMedSuche in Google Scholar
  • 32 Mallamaci F, Ruggenenti P, Perna A, Leonardis D, Tripepi R, Tripepi G, Remuzzi G, Zoccali C. REIN Study Group . ACE inhibition is renoprotective among obese patients with proteinuria. J Am Soc Nephrol 2011; 22: 1122-1128
    CrossrefPubMedSuche in Google Scholar
  • 33 Knight SF, Imig JD. Obesity, insulin resistance, and renal function. Microcirculation 2007; 14: 349-362
    CrossrefPubMedSuche in Google Scholar
  • 34 Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol 2003; 14: 1480-1486
    CrossrefPubMedSuche in Google Scholar
  • 35 Navaneethan SD, Yehnert H, Moustarah F, Schreiber MJ, Schauer PR, Beddhu S. Weight loss interventions in chronic kidney disease: A systematic review and meta-analysis. Clin J Am Soc Nephrol 2009; 4: 1565-1574
    CrossrefPubMedSuche in Google Scholar
  • 36 Ahmadi SF, Zahmatkesh G, Ahmadi E, Streja E, Rhee CM, Gillen DL, De Nicola L, Minutolo R, Ricardo AC, Kovesdy CP, Kalantar-Zadeh K. Association of Body Mass Index with Clinical Outcomes in Non-Dialysis-Dependent Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Cardiorenal Med 2015; 6: 37-49
    PubMedSuche in Google Scholar
  • 37 Afshinnia F, Wilt TJ, Duval S, Esmaeili A, Ibrahim HN. Weight loss and proteinuria: Systematic review of clinical trials and comparative cohorts. Nephrol Dial Transplant 2010; 25: 1173-1183
    CrossrefPubMedSuche in Google Scholar