Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study Journal Article


Authors: Kramer, H; Gutierrez, O. M.; Judd, S. E.; Muntner, P; Warnock, D. G.; Tanner, R. M.; Panwar, B.; Shoham, D. A.; McClellan, W.
Article Title: Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
Abstract: BACKGROUND: The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored. STUDY DESIGN: Longitudinal population-based cohort. SETTING PARTICIPANTS: Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n=30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n=26,960). PREDICTOR: Elevated waist circumference or BMI. OUTCOMES MEASUREMENTS: Incident cases of ESRD were identified through linkage of REGARDS participants with the US Renal Data System. RESULTS: Mean baseline age was 64.8 years, 45.8% were men, and 40.3% were black. Overall, 297 (1.1%) individuals developed ESRD during a median of 6.3 years. After adjustment for all covariates including waist circumference, no significant association was noted between BMI categories and ESRD incidence compared to BMI of 18.5 to 24.9kg/m2 (referent). Higher waist circumference categories showed significantly increased hazard rates of ESRD, with waist circumference >/= 108cm in women and >/=122cm in men (highest category) showing a 3.97-fold higher hazard rate (95% CI, 2.10-6.86) for ESRD compared to waist circumference 60mL/min/1.73m2. CONCLUSIONS: In this cohort of older adults, obesity as measured by waist circumference is associated with higher ESRD risk even with adjustment for BMI, whereas obesity as measured by BMI is not associated with higher ESRD risk after adjustment for waist circumference. However, no significant association is noted between increased waist circumference and ESRD risk after adjustment for obesity-related comorbid conditions, eGFR, and ACR.
Journal Title: American Journal of Kidney Diseases : The Official Journal of the National Kidney Foundation
ISSN: 1523-6838; 0272-6386
Publisher: Elsevier Inc  
Date Published: 2015
Language: ENG
DOI/URL:
Notes: LR: 20150719; CI: Copyright (c) 2015; JID: 8110075; OTO: NOTNLM; 2015/01/26 [received]; 2015/05/18 [accepted]; aheadofprint