Yoon Ji Kim1, Seun Deuk Hwang2, Tae Jung Oh3, Kyoung Min Kim3, Hak Chul Jang3, Heejin Kimm4, Hyeon Chang Kim5,6, Sun Ha Jee4, Soo Lim3. 1. 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Mediplex Sejong Hospital , Incheon, South Korea . 2. 2 Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine , Incheon, South Korea . 3. 3 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea . 4. 4 Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University , Seoul, South Korea . 5. 5 Department of Preventive Medicine, Yonsei University College of Medicine , Seoul, South Korea . 6. 6 Department of Preventive Medicine, Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine , Seoul, South Korea .
Abstract
BACKGROUND: Chronic kidney disease (CKD) has often been defined based on glomerular filtration rate (GFR) alone. The Kidney Disease: Improving Global Outcomes guideline highlights albuminuria in the CKD definition. Thus, we investigated the association between obesity and CKD, as defined by both GFR and albuminuria, in Korean adults. METHODS: We used Korea National Health and Nutrition Examination Survey 2011-2014 data (N = 19,331, ≥19 years old) representing the national Korean population. CKD was classified by (1) estimated GFR (eGFR) < 60 mL/min/1.73 m2 (CKDGFR); (2) albumin-to-creatinine ratio (ACR) ≥30 mg/gram (CKDACR); and (3) eGFR < 60 mL/min/1.73 m2 or ACR ≥30 mg/gram (CKDRisk). Associations between obesity and each CKD category were evaluated using multivariate logistic regression analysis. RESULTS: The prevalence rates of CKDGFR, CKDACR, and CKDRisk were 2.2%, 6.7%, and 8.1%, respectively. Compared with the normal body mass index (BMI; 18.5-22.9 kg/m2) group, men with BMI ≥ 25 kg/m2 had 1.88 times greater risk of CKDGFR in the adjusted model [95% confidence interval (CI), 1.26-2.80; P = 0.002]; BMI was not significantly associated with CKDGFR in women. In contrast, both men and women with BMI ≥ 25 kg/m2 had 1.58 and 1.40 times higher risk of CKDACR (95% CI, 1.21-2.07 and 1.08-1.81, respectively, both P < 0.01). Obese men and women had 1.65 and 1.38 times higher risk of CKDRisk (95% CI, 1.29-2.12 and 1.09-1.75, respectively, both P < 0.01). CONCLUSIONS: Obesity was significantly associated with an increased ACR-based CKD risk. Longitudinal studies are needed to investigate the role of overweight and obesity in the development and progression of CKD.
BACKGROUND:Chronic kidney disease (CKD) has often been defined based on glomerular filtration rate (GFR) alone. The Kidney Disease: Improving Global Outcomes guideline highlights albuminuria in the CKD definition. Thus, we investigated the association between obesity and CKD, as defined by both GFR and albuminuria, in Korean adults. METHODS: We used Korea National Health and Nutrition Examination Survey 2011-2014 data (N = 19,331, ≥19 years old) representing the national Korean population. CKD was classified by (1) estimated GFR (eGFR) < 60 mL/min/1.73 m2 (CKDGFR); (2) albumin-to-creatinine ratio (ACR) ≥30 mg/gram (CKDACR); and (3) eGFR < 60 mL/min/1.73 m2 or ACR ≥30 mg/gram (CKDRisk). Associations between obesity and each CKD category were evaluated using multivariate logistic regression analysis. RESULTS: The prevalence rates of CKDGFR, CKDACR, and CKDRisk were 2.2%, 6.7%, and 8.1%, respectively. Compared with the normal body mass index (BMI; 18.5-22.9 kg/m2) group, men with BMI ≥ 25 kg/m2 had 1.88 times greater risk of CKDGFR in the adjusted model [95% confidence interval (CI), 1.26-2.80; P = 0.002]; BMI was not significantly associated with CKDGFR in women. In contrast, both men and women with BMI ≥ 25 kg/m2 had 1.58 and 1.40 times higher risk of CKDACR (95% CI, 1.21-2.07 and 1.08-1.81, respectively, both P < 0.01). Obese men and women had 1.65 and 1.38 times higher risk of CKDRisk (95% CI, 1.29-2.12 and 1.09-1.75, respectively, both P < 0.01). CONCLUSIONS:Obesity was significantly associated with an increased ACR-based CKD risk. Longitudinal studies are needed to investigate the role of overweight and obesity in the development and progression of CKD.