WASHINGTON — Add chronic kidney disease to the list of problems linked with obesity.
That's the conclusion from data presented by Rebecca P. Gelber, M.D., at a conference on cardiovascular disease epidemiology and prevention sponsored by the American Heart Association.
Diabetes and hypertension, as well as increasing age, have been established previously as risk factors for chronic kidney disease, whereas obesity is a primary risk factor for both diabetes and hypertension. But new data from the prospective Physicians' Health Study are the first to independently link body mass index (BMI) with the development of chronic kidney disease, said Dr. Gelber of Harvard Medical School and the Massachusetts Veterans Epidemiology Research and Information Center, Boston.
Blood samples were available at 14-year follow-up for 11,104 initially healthy male study participants (mean age 53 years). At baseline, about 38% of the subjects were overweight (BMI of 25–29.9 kg/m
As expected, the overweight and obese men were more likely during the study period to have hypertension, diabetes, or cardiovascular events. They were also more likely to smoke, reported less alcohol consumption, were less physically active, and were more likely to report a family history of MI.
At follow-up, chronic kidney disease—defined as an estimated glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m
Higher baseline BMI was consistently associated with increased risk for chronic kidney disease. Compared with participants in the lowest quintile of BMI (less than 22.7), the odds ratio for those in the highest quintile (greater than 26.6) was 1.42.
After adjustment for potential baseline confounders (age, alcohol consumption, exercise, smoking, and parental history of MI) as well as potential mediators of the association between BMI and chronic kidney disease (hypertension, diabetes, cholesterol, and cardiovascular disease), the relationship was attenuated but still significant, with an odds ratio of 1.24, Dr. Gelber reported at the meeting, also sponsored by the National Heart, Lung, and Blood Institute.
The association between BMI and chronic kidney disease remained significant, to a similar degree, when subjects were divided into normal, overweight, and obese BMI categories, when the definition of chronic kidney disease was narrowed to GFR less than 50, and when the men who were obese at baseline were excluded.
These findings support previous data suggesting that similar predisposing factors underlie both chronic kidney disease and CVD, Dr. Gelber noted.