Metabolic abnormalities, but not obesity per se, associated with chronic kidney disease in a Taiwanese population

Chen, Hung Yu; Lu, Feng Hwa; Chang, Chih Jen; Wang, Ruh Sueh; Yang, Yi Ching; Chang, Yin Fan; Wu, Jin Shang

doi:10.1016/j.numecd.2019.09.029

Cited by 16 publications

(22 citation statements)

References 54 publications

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“…47,48 Risk factor distribution may also differ between men and women and tends to increase with age; therefore, local epidemiology is relevant in development of strategies to address local risk factor burdens. 49,50 In many regions, metabolic risk factors are the major drivers of CKD risk, 47,50 and indeed, diabetes remains the most common cause of CKD globally. 13 The contribution of hypertension to the burden of CKD in developed countries is more variable but remains significant.…”

Section: Mitigation Of Major Traditional Risk Factors For Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

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Chronic kidney disease (CKD) is an important public health concern in developed countries because of both the number of people affected and the high cost of care when prevention strategies are not effectively implemented. Prevention should start at the governance level with the institution of multisectoral polices supporting sustainable development goals and ensuring safe and healthy environments. Primordial prevention of CKD can be achieved through implementation of measures to ensure healthy fetal (kidney) development. Public health strategies to prevent diabetes, hypertension, and obesity as risk factors for CKD are important. These approaches are cost-effective and reduce the overall noncommunicable disease burden. Strategies to prevent nontraditional CKD risk factors, including nephrotoxin exposure, kidney stones, infections, environmental exposures, and acute kidney injury (AKI), need to be tailored to local needs and epidemiology. Early diagnosis and treatment of CKD risk factors such as diabetes, obesity, and hypertension are key for primary prevention of CKD. CKD tends to occur more frequently and to progress more rapidly among indigenous, minority, and socioeconomically disadvantaged populations. Special attention is required to meet the CKD prevention needs of these populations. Effective secondary prevention of CKD relies on screening of individuals at risk to detect and treat CKD early, using established and emerging strategies. Within high-income countries, barriers to accessing effective CKD therapies must be recognized, and public health strategies must be developed to overcome these obstacles, including training and support at the primary care level to identify individuals at risk of CKD, and appropriately implement clinical practice guidelines.

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Section: Mitigation Of Major Traditional Risk Factors For Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

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“…The study suggested that BMI per se is not an independent risk factor for CKD. 32 Moreover, a cohort study of 453,946 American veterans with an eGFR lower than 60 mL/min per 1.73m 2 obtained a U-shaped association between BMI and the progression of renal disease, with the best outcomes observed in overweight and mildly obese subjects. 33 In our study, the significant association between BMI per se and eGFR confirms some of the previous evidence.…”

Section: Discussionmentioning

confidence: 98%

Combined Effects of Dyslipidemia and High Adiposity on the Estimated Glomerular Filtration Rate in a Middle-Aged Chinese Population

Wang¹,

Wang²,

Li³

et al. 2021

DMSO

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“…Metabolically healthy obesity (MHO) is an obesity phenotype that obesity is not associated with metabolic complications such as insulin resistance, inflammation, hypertension, or T2D. Compared with metabolically healthy non-obesity phenotype, the odds ratios for incident CKD for MHO were similar to the comparison group, but significantly increased for metabolically abnormal non-obese and obesity phenotype respectively after adjustment for confounders [29][30][31]. However, other studies reported that MHO may have an intermediate future risk to develop ESKD.…”

Section: Epidemiologymentioning

confidence: 99%

Impact of Obesity in Kidney Diseases

et al. 2021

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The clinical consequences of obesity on the kidneys, with or without metabolic abnormalities, involve both renal function and structures. The mechanisms linking obesity and renal damage are well understood, including several effector mechanisms with interconnected pathways. Higher prevalence of urinary albumin excretion, sub-nephrotic syndrome, nephrolithiasis, increased risk of developing CKD, and progression to ESKD have been identified as being associated with obesity and having a relevant clinical impact. Moreover, renal replacement therapy and kidney transplantation are also influenced by obesity. Losing weight is key in limiting the impact that obesity produces on the kidneys by reducing albuminuria/proteinuria, declining rate of eGFR deterioration, delaying the development of CKD and ESKD, and improving the outcome of a renal transplant. Weight reduction may also contribute to appropriate control of cardiometabolic risk factors such as hypertension, metabolic syndrome, diabetes, and dyslipidemia which may be protective not only in renal damage but also cardiovascular disease. Lifestyle changes, some drugs, and bariatric surgery have demonstrated the benefits.

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Metabolic abnormalities, but not obesity per se, associated with chronic kidney disease in a Taiwanese population

Cited by 16 publications

References 54 publications

Preventing CKD in Developed Countries

Preventing CKD in Developed Countries

Combined Effects of Dyslipidemia and High Adiposity on the Estimated Glomerular Filtration Rate in a Middle-Aged Chinese Population

Impact of Obesity in Kidney Diseases

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