BACKGROUND: Prior research yielded conflicting results about the magnitude of the association between body mass index (BMI) and chronic kidney disease (CKD). STUDY DESIGN: Prospective cohort study. SETTINGS & PARTICIPANTS: Framingham Offspring participants (n = 2,676; 52% women; mean age, 43 years) free of stage 3 CKD at baseline who participated in examination cycles 2 (1978-1981) and 7 (1998-2001). PREDICTOR: BMI. OUTCOME: Stage 3 CKD (estimated glomerular filtration rate < 59 mL/min/1.73 m(2) for women and < 64 mL/min/1.73 m(2) for men). MEASUREMENTS: Age-, sex-, and multivariable-adjusted (diabetes, systolic blood pressure, hypertension treatment, current smoking status, and high-density lipoprotein cholesterol level) logistic regression models were used to examine the relationship between BMI at baseline and incident stage 3 CKD and incident dipstick proteinuria (trace or greater). RESULTS: At baseline, 36% of the sample was overweight and 12% was obese; 7.9% (n = 212) developed stage 3 CKD during 18.5 years of follow-up. Relative to participants with normal BMI, there was no association between overweight individuals and stage 3 CKD incidence in age- and sex-adjusted models (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.93 to 1.81; P = 0.1) or multivariable models (OR, 1.06; 95% CI, 0.75 to 1.50; P = 0.8). Obese individuals had a 68% increased odds of developing stage 3 CKD (OR, 1.68; 95% CI, 1.10 to 2.57; P = 0.02), which became nonsignificant in multivariable models (OR, 1.09; 95% CI, 0.69 to 1.73; P = 0.7). Similar findings were observed when BMI was modeled as a continuous variable or quartiles. Incident proteinuria occurred in 14.4%; overweight and obese individuals were at increased odds of proteinuria in multivariable models (OR, 1.43; 95% CI, 1.09 to 1.88; OR, 1.56; 95% CI, 1.08 to 2.26, respectively). LIMITATIONS: BMI is measure of generalized obesity and not abdominal obesity. Participants are predominantly white, and these findings may not apply to different ethnic groups. CONCLUSIONS: Obesity is associated with increased risk of developing stage 3 CKD, which was no longer significant after adjustment for known cardiovascular disease risk factors. The relationship between obesity and stage 3 CKD may be mediated through cardiovascular disease risk factors.
BACKGROUND: Prior research yielded conflicting results about the magnitude of the association between body mass index (BMI) and chronic kidney disease (CKD). STUDY DESIGN: Prospective cohort study. SETTINGS & PARTICIPANTS: Framingham Offspring participants (n = 2,676; 52% women; mean age, 43 years) free of stage 3 CKD at baseline who participated in examination cycles 2 (1978-1981) and 7 (1998-2001). PREDICTOR: BMI. OUTCOME: Stage 3 CKD (estimated glomerular filtration rate < 59 mL/min/1.73 m(2) for women and < 64 mL/min/1.73 m(2) for men). MEASUREMENTS: Age-, sex-, and multivariable-adjusted (diabetes, systolic blood pressure, hypertension treatment, current smoking status, and high-density lipoprotein cholesterol level) logistic regression models were used to examine the relationship between BMI at baseline and incident stage 3 CKD and incident dipstick proteinuria (trace or greater). RESULTS: At baseline, 36% of the sample was overweight and 12% was obese; 7.9% (n = 212) developed stage 3 CKD during 18.5 years of follow-up. Relative to participants with normal BMI, there was no association between overweight individuals and stage 3 CKD incidence in age- and sex-adjusted models (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.93 to 1.81; P = 0.1) or multivariable models (OR, 1.06; 95% CI, 0.75 to 1.50; P = 0.8). Obese individuals had a 68% increased odds of developing stage 3 CKD (OR, 1.68; 95% CI, 1.10 to 2.57; P = 0.02), which became nonsignificant in multivariable models (OR, 1.09; 95% CI, 0.69 to 1.73; P = 0.7). Similar findings were observed when BMI was modeled as a continuous variable or quartiles. Incident proteinuria occurred in 14.4%; overweight and obese individuals were at increased odds of proteinuria in multivariable models (OR, 1.43; 95% CI, 1.09 to 1.88; OR, 1.56; 95% CI, 1.08 to 2.26, respectively). LIMITATIONS: BMI is measure of generalized obesity and not abdominal obesity. Participants are predominantly white, and these findings may not apply to different ethnic groups. CONCLUSIONS:Obesity is associated with increased risk of developing stage 3 CKD, which was no longer significant after adjustment for known cardiovascular disease risk factors. The relationship between obesity and stage 3 CKD may be mediated through cardiovascular disease risk factors.
Authors: Andrew S Levey; Josef Coresh; Tom Greene; Lesley A Stevens; Yaping Lucy Zhang; Stephen Hendriksen; John W Kusek; Frederick Van Lente Journal: Ann Intern Med Date: 2006-08-15 Impact factor: 25.391
Authors: Josef Coresh; Elizabeth Selvin; Lesley A Stevens; Jane Manzi; John W Kusek; Paul Eggers; Frederick Van Lente; Andrew S Levey Journal: JAMA Date: 2007-11-07 Impact factor: 56.272
Authors: Aminu K Bello; Dick de Zeeuw; Meguid El Nahas; Auke H Brantsma; Stephan J L Bakker; Paul E de Jong; Ronald T Gansevoort Journal: Nephrol Dial Transplant Date: 2007-03-14 Impact factor: 5.992
Authors: Meredith C Foster; Shih-Jen Hwang; Martin G Larson; Nisha I Parikh; James B Meigs; Ramachandran S Vasan; Thomas J Wang; Daniel Levy; Caroline S Fox Journal: Arch Intern Med Date: 2007-07-09
Authors: Meredith C Foster; Shih-Jen Hwang; Stacy A Porter; Joseph M Massaro; Udo Hoffmann; Caroline S Fox Journal: Hypertension Date: 2011-09-19 Impact factor: 10.190
Authors: Auni Juutilainen; Helena Kastarinen; Riitta Antikainen; Markku Peltonen; Veikko Salomaa; Jaakko Tuomilehto; Pekka Jousilahti; Jouko Sundvall; Tiina Laatikainen; Mika Kastarinen Journal: Eur J Epidemiol Date: 2012-04 Impact factor: 8.082
Authors: Jun Ling Lu; Kamyar Kalantar-Zadeh; Jennie Z Ma; L Darryl Quarles; Csaba P Kovesdy Journal: J Am Soc Nephrol Date: 2014-03-20 Impact factor: 10.121
Authors: Lori D Bash; Josef Coresh; Anna Köttgen; Rulan S Parekh; Tibor Fulop; Yaping Wang; Brad C Astor Journal: Am J Epidemiol Date: 2009-06-17 Impact factor: 4.897
Authors: Seyed-Foad Ahmadi; Golara Zahmatkesh; Emad Ahmadi; Elani Streja; Connie M Rhee; Daniel L Gillen; Luca De Nicola; Roberto Minutolo; Ana C Ricardo; Csaba P Kovesdy; Kamyar Kalantar-Zadeh Journal: Cardiorenal Med Date: 2015-10-16 Impact factor: 2.041
Authors: Ian H de Boer; Ronit Katz; Linda F Fried; Joachim H Ix; Jose Luchsinger; Mark J Sarnak; Michael G Shlipak; David S Siscovick; Bryan Kestenbaum Journal: Am J Kidney Dis Date: 2009-09-25 Impact factor: 8.860