Body Mass Index and Risk of ESRD in China

Reynolds, Kristi; Gu, Dongfeng; Muntner, Paul; Chen, Jing; Wu, Xigui; Yau, C. Lillian; Duan, Xin; Chen, Chung-Shiuan; Hamm, L. Lee; He, Jiang

doi:10.1053/j.ajkd.2007.08.011

Cited by 47 publications

(33 citation statements)

References 29 publications

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“…A large study using health care data found positive associations between overweight and obesity with incident ESRD (2). Similar results were described in a large Chinese study (3) but not among United States veterans (23). Mechanisms related to the development of CKD and progression to ESRD are still poorly understood, especially the racial/ethnic differences in incident ESRD.…”

Section: Introductionsupporting

confidence: 85%

“…Evidence from observational studies suggests that both overall and central obesity, assessed by waist circumference or waist-to-hip ratio, are associated with incident CKD in populations (16)(17)(18)(19)(20)(21)(22). However, the association between obesity and ESRD has been inconsistent (2,3), and assessment of central adiposity measures for ESRD risk has yet to be studied, particularly among postmenopausal women. A large study using health care data found positive associations between overweight and obesity with incident ESRD (2).…”

Section: Introductionmentioning

confidence: 99%

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Adiposity Patterns and the Risk for ESRD in Postmenopausal Women

Franceschini¹,

Gouskova

Reiner

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Body mass index and waist circumference associate with adverse health outcomes, including CKD. Studies of the association of body mass index and ESRD have been inconsistent; these adiposity measures have not been previously assessed together for ESRD risk or among postmenopausal women.Design, settings, participants, & measurements This was prospective cohort study of 20,117 postmenopausal women enrolled in the multiethnic cohort of the Women's Health Initiative. Body mass index and waist circumference were obtained at baseline, incident ESRD was obtained from the US Renal Data System, and all-cause death was obtained from surveillance data. A competing-risk framework was used to account for the effect of mortality before ESRD while adjusting for significant predictors and baseline kidney function. Associations of adiposity with mortality were also studied.Results Events included 212 patients with incident ESRD and 3104 deaths for a mean follow-up of 11.6 years. Increased waist circumference and body mass index were associated with 2.59-(95% confidence interval, 1.89 to 3.53) and 1.97-fold (95% confidence interval, 1.30 to 2.98) higher hazards of ESRD as well as 1.42-(95% confidence interval, 1.32 to 1.53) and 1.21-fold (95% confidence interval, 1.11 to 1.33) higher hazards of death, respectively, compared with the lower categories in adjusted analyses. The associations of waist circumference with ESRD varied by baseline renal function (P for interaction=0.01) and were significant only among women without baseline eGFR-defined CKD (hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.03).Conclusions Central obesity was associated with an increased risk of ESRD in postmenopausal women, even among women with normal body mass index but not among women with reduced baseline kidney function, and an increased risk of death. Body mass index was associated with ESRD, and the association is likely mediated through hypertension and diabetes.

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Section: Introductionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Adiposity Patterns and the Risk for ESRD in Postmenopausal Women

Franceschini¹,

Gouskova

Reiner

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…A recent prospective study showed a J-shaped relationship between BMI and the risk for ESRD in China. 34 In addition, all-cause mortality studies have reported U-shaped or J-shaped relationships between BMI and mortality. [35][36][37][38][39] In this study, the underweight individuals (BMI Ͻ18.5 kg/m 2 ) had NS increases in CKD risk compared with normal-weight men (18.5 ՅBMI Ͻ23.0 kg/m 2 ).…”

Section: ͻ0001mentioning

confidence: 99%

Changes in Body Weight Predict CKD in Healthy Men

Ryu¹,

Chang²,

Woo³

et al. 2008

Journal of the American Society of Nephrology

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Several recent prospective studies have reported that obesity is associated with an increased risk for chronic kidney disease (CKD), but it is unknown whether weight gain increases the risk for CKD if one remains within the "normal" category of body mass index (BMI). We prospectively followed a cohort of 8792 healthy men who had no known risk factors for CKD and participated in a comprehensive health evaluation program at a large worksite. During 35,927 person-years of follow-up, 427 new incident cases of CKD (estimated GFR Ͻ64 ml/min per 1.73 m 2 ) developed. Cox proportional hazards modeling revealed that in both the normal-weight and overweight groups, a U-shaped association between weight change categories and development of CKD was observed after adjustment for age, baseline GFR, baseline BMI, HDL, fasting blood glucose, uric acid, and exercise habits. The lowest risk for CKD was observed among those whose weight changed Ϫ0.25 to Ͻ0.25 kg/yr (P Ͻ 0.001 for quadratic term). Weight change as a time-dependent variable was significantly related to CKD incidence. These relationships remained significant even after further adjustment for Homeostasis Model Assessment of Insulin Resistance, high-sensitivity C-reactive protein, systolic BP, diastolic BP, metabolic syndrome, incident hypertension, or incident diabetes. In summary, increases in body weight are independently associated with an increased risk for CKD, even when the BMI remains within the normal range.

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“…These factors were selected a priori based on the existing literature and data availability 16,30,31,32,33 .…”

Section: Methodsmentioning

confidence: 99%

Serum Urate and Incidence of Kidney Disease Among Veterans with Gout

Krishnan

Akhras²,

Sharma³

et al. 2013

J Rheumatol

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Objective.To study the association between serum urate level (sUA) and the risk of incident kidney disease among US veterans with gouty arthritis.Methods.From 2002 through 2011 adult male patients with gout who were free of kidney disease were identified in the data from the Veterans Administration VISN 16 database and were followed until incidence of kidney disease, death, or the last available observation. Accumulated hazard curves for time to kidney disease were estimated for patients with average sUA levels > 7 mg/dl (high) versus ≤ 7 mg/dl (low) based on Kaplan-Meier analyses; and statistical comparison was conducted using a log-rank test. A Cox proportional hazard model with time-varying covariates was used to estimate the unadjusted and adjusted hazard ratios for kidney disease.Results.Eligible patients (n = 2116) were mostly white (53%), with average age 62.6 years, mean body mass index 31.2 kg/m2, and high baseline prevalence of hypertension (93%), hyperlipidemia (67%), and diabetes (20%). Mean followup time was 6.5 years. The estimated rates of all incident kidney disease in the overall low versus high sUA groups were 2% versus 4% at Year 1, 3% versus 6% at Year 2, and 5% versus 9% at Year 3, respectively (p < 0.0001). After adjustment, high sUA continued to predict a significantly higher risk of kidney disease development (HR 1.43, 95% CI 1.20–1.70).Conclusion.Male veterans with gout and sUA levels > 7 mg/dl had an increased incidence of kidney disease.

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Body Mass Index and Risk of ESRD in China

Cited by 47 publications

References 29 publications

Adiposity Patterns and the Risk for ESRD in Postmenopausal Women

Adiposity Patterns and the Risk for ESRD in Postmenopausal Women

Changes in Body Weight Predict CKD in Healthy Men

Serum Urate and Incidence of Kidney Disease Among Veterans with Gout

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