Obesity as a predictive factor for chronic kidney disease in adults: systematic review and meta-analysis

Abstract

Chronic kidney disease (CKD) is one of the main chronic diseases affecting the world population due to its high prevalence and increasing morbidity. Similarly, obesity gained the interest of the scientific community as it directly or indirectly increases mortality from cardiovascular causes, and its prevalence characterizes a pandemic. The objective of this study was to investigate obesity measured by body mass index as a predictor for end-stage renal disease in the general adult population. A systematic review and meta-analysis was carried out by searching 10 databases for prospective or retrospective cohort studies, with no restrictions on the language of publication, including adults with obesity without previous renal disease and who evolved to CKD (diagnosed by estimated glomerular filtration rate below 60 mL&mac_middot;min -1 &mac_middot;(1.73 m 2 ) -1 over the follow-up period. The R software and Meta package were used for data analysis. After removing duplicates, 5431 studies were submitted to the steps of the systematic review, and 21 articles were included in the data analysis. In total, 3,504,303 patients, 521,216 with obesity, and an average follow-up time of 9.86 years were included. The relative risk of obese people for developing CKD in the random effects model was 1.81 (95%CI: 1.52-2.16). The evidence found in this meta-analysis confirmed that obese people are at higher risk of developing CKD that the non-obese population (1.81 times higher), with obesity being a priority risk factor in preventive actions.

Irisin protects against obesity-related chronic kidney disease by regulating perirenal adipose tissue function in obese mice

“…Obesity-related chronic kidney disease (OB-CKD) is receiving increasing attention because of the obesity pandemic [ 1 – 3 ]. OB-CKD is characterized by glomerular hypertrophy and microalbuminuria, which are also markers of systemic vascular endothelial cell lesions that involve renal arteries and glomerular endothelial cells [ 4 , 5 ].…”

Risk Factors of Chronic Kidney Disease (CKD) in Type 2 Diabetes Mellitus (DM) Patients at Dr. Soetomo General Academic Hospital, Surabaya

“…25 However, Pinto, et al (2021) found that people with obesity had a 1.81 times higher risk of developing CKD (OR = 1.81, 95% CI = 1.52-2.16). 26 The experimental research using rats by Salim et al (2018) showed that a high-fat diet, which results in obesity, could damage the kidney by contributing to glomerulosclerosis, tubular defects, inflammation, and other histopathological changes in the 27 Chang, et al (2018) explained that the measured BMI did not fully represent the variation in the composition of each body. Therefore, BMI was not accurate enough to determine its effect on CKD.…”

Evaluation of glomerular hyper filtration in obesity: Which formula to use?

“…Obesity is associated with a low-grade inflammatory state, oxidative stress, abnormal lipid metabolism, activation of the renin-angiotensin-aldosterone system and increased insulin production, including accumulation of ectopic lipids and increased deposition of renal sinus fat. These different effects lead to specific pathological changes in the kidney that may be responsible for the higher risk of CKD seen in observational studies (7,9).…”