Waist-to-Hip Ratio, Body Mass Index, and Subsequent Kidney Disease and Death

Elsayed, Essam F.; Sarnak, Mark J.; Tighiouart, Hocine; Griffith, John L.; Kurth, Tobias; Salem, Deeb N.; Levey, Andrew S.; Weiner, Daniel E.

doi:10.1053/j.ajkd.2008.02.363

Cited by 226 publications

(184 citation statements)

References 28 publications

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“…The consequence of abdominal adiposity in relation to kidney function impairment has been little documented and it is a noteworthy subject, considering its frequent association with hypertension and diabetes, which are the main causes of CKD in the world. Some studies have shown an association between the central distribution of fat, measured by the WHR, with hypertension 14,27 , microalbuminuria 28 and CKD 29 .…”

Section: Discussionmentioning

confidence: 99%

Filtração glomerular e fatores associados em hipertensos atendidos na atenção básica

França

Santos

Calado

et al. 2010

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Filtração glomerular e fatores associados em hipertensos atendidos na atenção básica

França

Santos

Calado

et al. 2010

Arq. Bras. Cardiol.

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“…107 Because the metabolically more active visceral fat depots are the key factor in the development of insulin resistance, hypertension, fatty liver, type 2 diabetes, and atherosclerosis, 46 nephrologists should estimate fat distribution. Indeed, the gene expression differs markedly between visceral and subcutaneous fat depots, 108 and studies in the general population 109 and CKD 110 and dialysis patients 111 show that increased WC (or WHR) was related to a higher risk of death from major specific causes independent of BMI. In accordance, visceral obesity is linked to inflammation, protein energy wasting, and worse outcome in hemodialysis patients.…”

Section: Should Nephrologists Promote Weight Gain In Dialysis Patients?mentioning

confidence: 99%

Obesity in CKD—What Should Nephrologists Know?

Stenvinkel

Zoccali

İkizler

2013

Journal of the American Society of Nephrology

196

172

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Obesity, the epidemic of the 21st century, carries a markedly increased risk for comorbid complications, such as type 2 diabetes, cancer, hypertension, dyslipidemia, cardiovascular disease, and sleep apnea. In addition, obesity increases the risk for CKD and its progression to ESRD. Paradoxically, even morbid obesity associates with better outcomes in studies of ESRD patients on maintenance dialysis. Because the number of obese CKD and maintenance dialysis patients is projected to increase markedly in developed as well as low-and middle-income countries, obesity is a rapidly emerging problem for the international renal community. Targeting the obesity epidemic represents an unprecedented opportunity for health officials to ameliorate the current worldwide increase in CKD prevalence. Nephrologists need more information about assessing and managing obesity in the setting of CKD. Specifically, more precise estimation of regional fat distribution and the amount of muscle mass should be introduced into regular clinical practice to complement more commonly used practical markers, such as body mass index. Studies examining the effects of obesity on kidney disease progression and other clinical outcomes along with weight management strategies are much needed in this orphan area of research. 24: 172724: -173624: , 201324: . doi: 10.1681 Obesity has emerged as the largest pandemic in near history, with important implications of not only cardiovascular disease (CVD) but also CKD. Recent data from the United States indicate that the incidence and prevalence rates of obesity in maintenance dialysis patients largely exceed the corresponding figures in the general population. 1 A large European population survey documented that a high body mass index (BMI) ranks as one of the strongest risk factors for new-onset CKD. 2 The dimension of the obesity epidemic and the impact of the same epidemic on the kidney demand efforts for understanding the epidemiology and the mechanisms of CKD associated with excess adiposity. It also sets as an absolute public health priority for the development of treatment policies integrated across specialties and general practice to halt this much concerning problem. In this scenario, it is fundamental that nephrologists are updated on current knowledge about obesity in the setting of CKD. However, little attention is still paid to this issue in major nephrology journals. The suboptimal attention to the problem by major sources of dissemination of specialty information suggests that nephrologists may have scarce knowledge of how obesity should be assessed, its epidemiology, mechanisms whereby excess fat mass is conducive to CKD, and management of obesity in the catabolic uremic milieu. 3 J Am Soc Nephrol DEFINITION AND ASSESSMENT OF OBESITYThe most common method for defining obesity is based on BMI (i.e., a person's weight as obese. It should be emphasized that population norms of BMI could be different based on ethnic and racial background (i.e., the proportion of Asian people with a high ...

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“…[1][2][3] This increased risk is often attributed to associated conditions, such as weight excess, hypertension, dyslipidemia, and diabetes. [4][5][6][7][8][9][10] However, after adjustment for these conditions, central body fat distribution, estimated from waist-to-hip ratio (WHR), remains an independent determinant of increased long-term renal risk.…”

mentioning

confidence: 99%

“…[4][5][6][7][8][9][10] However, after adjustment for these conditions, central body fat distribution, estimated from waist-to-hip ratio (WHR), remains an independent determinant of increased long-term renal risk. [1][2][3] The mechanisms underlying this increased renal risk in association with a central body fat distribution are not well established. Small studies suggest that central body fat distribution is associated with an unfavorable renal hemodynamic profile; 11,12 however, these studies did not control for concomitant presence of overall weight excess as commonly reflected by body mass index (BMI), a well established determinant of an unfavorable renal hemodynamic profile in itself.…”

mentioning

confidence: 99%

Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

Kwakernaak

Zelle

Bakker

et al. 2013

Journal of the American Society of Nephrology

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Central distribution of body fat is associated with a higher risk of renal disease, but whether it is the distribution pattern or the overall excess weight that underlies this association is not well understood. Here, we studied the association between waist-to-hip ratio (WHR), which reflects central adiposity, and renal hemodynamics in 315 healthy persons with a mean body mass index (BMI) of 24.9 kg/m 2 and a mean 125 I-iothalamate GFR of 109 ml/min per 1.73 m 2 . In multivariate analyses, WHR was associated with lower GFR, lower effective renal plasma flow, and higher filtration fraction, even after adjustment for sex, age, mean arterial pressure, and BMI. Multivariate models produced similar results regardless of whether the hemodynamic measures were indexed to body surface area. Thus, these results suggest that central body fat distribution, independent of BMI, is associated with an unfavorable pattern of renal hemodynamic measures that could underlie the increased renal risk reported in observational studies.

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Waist-to-Hip Ratio, Body Mass Index, and Subsequent Kidney Disease and Death

Abstract: Background-Chronic kidney disease (CKD) and obesity are important public health concerns. We examined the association between anthropomorphic measures and incident CKD and mortality.

Cited by 226 publications

References 28 publications

Filtração glomerular e fatores associados em hipertensos atendidos na atenção básica

Filtração glomerular e fatores associados em hipertensos atendidos na atenção básica

Obesity in CKD—What Should Nephrologists Know?

Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

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