Overweight and obesity are associated with increased cardiovascular risk. Some studies have demonstrated that they also can result in renal damage. The aim of this study was to assess the prevalence of renal insufficiency (RI), defined as a GFR <60 ml/min per 1.73 m 2 , in a cohort of 4585 patients who attended primary care with essential hypertension and a body mass index >25 kg/m 2 . The patients were classified as overweight and obese according to body mass index (25 to 29.9 and >30 kg/m 2 , respectively). Abdominal obesity was defined as a waist circumference >88 and 102 cm in women and men, respectively. Both groups had a high prevalence of metabolic syndrome (Adult Treatment Panel III). The prevalence of RI was high in both the overweight group (22.7%; 95% confidence interval [CI] 20.6 to 24.9) and in the obese group (22.8%; 95% CI 21.0 to 24.7). The presence of diabetes increased the risk for RI (odds ratio 1.83; 95% CI 1.55 to 2.16). The prevalence of RI was greater in patients with abdominal obesity (23 versus 17%; P < 0.001). In the presence of abdominal obesity, cardiovascular risk factors and components of the metabolic syndrome also were more prevalent. The higher risk for RI with abdominal obesity persisted even after adjustment for dyslipidemia, elevated blood glucose levels, and other variables that are associated with RI (adjusted odds ratio 1.40; 95% CI 0.84 to 2.33). It was concluded that patients who have hypertension and visceral obesity and attend primary care present a higher prevalence of metabolic syndrome and RI.J Am Soc Nephrol 17: S194 -S200, 2006. doi: 10.1681/ASN.2006080914 C hronic kidney disease (CKD) is a widely known cardiovascular risk factor. Renal insufficiency (RI) and micro-or macroalbuminuria, both manifestations of CKD, are associated with increased cardiovascular morbidity and mortality (1-4).The application of equations to estimate GFR has revealed an important and growing prevalence of CKD, associated with vascular events both in population-based studies and in patients with cardiovascular risk factors (5,6). Some epidemiologic studies have demonstrated an association between obesity and CKD. A high body mass index (BMI) increases the risk for a reduced GFR in both men and women (7). Obesity can be associated with glomerulosclerosis and also can facilitate a loss of renal function in patients with other kidney diseases (8,9). The risk for presenting RI as defined by a GFR Ͻ60 ml/min per 1.73 m 2 and end-stage renal failure as defined by the need for kidney transplant or dialysis increases with the rise in BMI (10,11).It therefore is likely that increased prevalence of CKD could be due, at least partially, to an increase in comorbidities such as overweight and obesity and the combination of associated hemodynamic and metabolic disorders that result in metabolic syndrome (MS). Awareness of the association between overweight/obesity and RI is important to adopt preventive and therapeutic measures for this risk factor of CKD. The present study assessed the prevalence of on...
The results of the study indicate that there is TI in 7 out every 10 visits made by hypertensive patients in Primary care. There are significant differences as regards the clinical characteristics of the patients and of the doctors.
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