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Open J Endocr Metab Dis. 2013 May 23;3(2):103-112.

Association of Obesity and Kidney Function Decline among Non-Diabetic Adults with eGFR > 60 ml/min/1.73m2: Results from the Multi-Ethnic Study of Atherosclerosis (MESA).

Author information

1
University of California, San Francisco, USA.
2
University of Washington, Seattle, USA.
3
University of California, San Francisco, USA ; San Francisco Veterans Affairs Medical Center, San Francisco, USA.
4
University of California, San Diego, USA.
5
Tufts Medical Center, Boston, USA.
6
Loyola University Medical Center, Maywood, USA.
7
Harvard University, Cambridge, USA.

Abstract

BACKGROUND:

Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized.

METHODS:

We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension.

RESULTS:

Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI < 25, overweight (BMI 25 - 30) persons had the lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers.

CONCLUSIONS:

Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.

KEYWORDS:

Kidney Function Decline; MESA; Obesity; Waist Circumference; Waist-to-Hip Ratio

PMID:
25210651
PMCID:
PMC4157691

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