Obesity, metabolic health, and the risk of end-stage renal disease Journal Article

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Authors: Panwar, B.; Hanks, L. J.; Tanner, R. M.; Muntner, P; Kramer, H; McClellan, W. M.; Warnock, D. G.; Judd, S. E.; Gutierrez, O. M.
Article Title: Obesity, metabolic health, and the risk of end-stage renal disease
Abstract: Obesity is associated with chronic kidney disease progression. Whether metabolic risk factors modify this association is unclear. Here we examined associations of body mass index (BMI) and metabolic health with risk of end-stage renal disease (ESRD) in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Among 21,840 participants eligible for analysis, 247 developed ESRD (mean follow-up of 6.3 years). Metabolic health significantly modified the association of BMI with ESRD. In models stratified by the presence or absence of the metabolic syndrome and adjusted for demographic, lifestyle, and clinical factors, higher BMI was associated with lower risk of ESRD in those without (hazard ratio per 5 kg/m2 increase in BMI 0.70, 95% CI 0.52, 0.95) but not those with (hazard ratio, 1.06) the metabolic syndrome. In models stratified by weight and metabolic health, compared with normal weight (BMI 18.5-24.9 kg/m2) participants without the metabolic syndrome the overweight individuals (BMI 25-29.9) and obese individuals (BMI of 30 or more) with the metabolic syndrome had greater risk of ESRD (hazard ratios of 2.03 and 2.29, respectively), whereas obesity without the metabolic syndrome was associated with lower risk of ESRD (hazard ratio 0.47). Thus, higher BMI is associated with lower ESRD risk in those without but not those with the metabolic syndrome.
Journal Title: Kidney international
Volume: 87
Issue: 6
ISSN: 1523-1755; 0085-2538
Publisher: Unknown  
Journal Place: United States
Date Published: 2015
Start Page: 1216
End Page: 1222
Language: eng
DOI/URL:

10.1038/ki.2014.384
Notes: LR: 20150531; GR: P30 DK079626/DK/NIDDK NIH HHS/United States; GR: R01 NS080850/NS/NINDS NIH HHS/United States; GR: R01NS080850/NS/NINDS NIH HHS/United States; GR: R03 DK095005/DK/NIDDK NIH HHS/United States; GR: R03DK095005/DK/NIDDK NIH HHS/United States; GR: U01 NS041588/NS/NINDS NIH HHS/United States; GR: U01 NS041588/NS/NINDS NIH HHS/United States; JID: 0323470; NIHMS643859; OID: NLM: NIHMS643859 [Available on 12/01/15]; OID: NLM: PMC4449828 [Available on 12/01/15]; PMCR: 2015/12/01 00:00; 2014/04/28 [received]; 2014/09/23 [revised]; 2014/09/25 [accepted]; 2014/12/17 [aheadofprint]; ppublish