scholarly journals Body mass index change and estimated glomerular filtration rate decline in a middle-aged population: health check-based cohort in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037247
Author(s):  
Shingo Fukuma ◽  
Tatsuyoshi Ikenoue ◽  
Jennifer Bragg-Gresham ◽  
Edward Norton ◽  
Yukari Yamada ◽  
...  

BackgroundObesity is a growing public health problem worldwide. We evaluated the mediators and association between changes in obesity metrics and renal outcomes in the general population.MethodsUsing the Japanese nationwide health check-based cohort from April 2011 to March 2019, we selected individuals aged 40–74 years, with a baseline estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m2, whose body mass index (BMI) change was assessed. The primary outcome was combined 30% decline in eGFR, eGFR <15 mL/min/1.73 m2 and end-stage renal disease.ResultsDuring 245 147 person-years’ follow-up among 50 604 participants (mean eGFR, 83.7 mL/min/1.73 m2; mean BMI, 24.1 kg/m2), 645 demonstrated eGFR decline (incidence rate 2.6/1000 person-years, 95% CI: 2.4 to 2.8). We observed continued initial changes in BMI for over 6 years and a U-shaped association between BMI change and eGFR decline. Compared with 0% change in BMI, adjusted HRs for changes of −10%, −4%, 4% and 10% were 1.53 (95% CI: 1.15 to 2.04), 1.14 (95% CI: 1.01 to 1.30), 1.16 (95% CI: 1.02 to 1.32) and 1.87 (95% CI: 1.25 to 2.80), respectively. The percentage of excess risk of BMI increase (>4%) mediated by three risk factors (blood pressure, haemoglobin A1c and total cholesterol), was 13.3%.ConclusionIn the middle-aged Japanese population, both, increase and decrease in BMI were associated with subsequent eGFR decline. Changes in risk factors mediated a small proportion of the association between BMI increase and eGFR decline. Our findings support the clinical significance of monitoring BMI as a renal risk factor.

2016 ◽  
Vol 62 (2) ◽  
pp. 225-229
Author(s):  
Carmen Denise Caldararu ◽  
Dorin Tarta ◽  
Raluca Pop ◽  
Mirela Gliga ◽  
Emilian Carasca ◽  
...  

AbstractObesity and chronic kidney disease are epidemic size. Chronic kidney disease (CKD) appears to be more common in obese, although interrelation is not supported by all authors.Aim: The aim of the study was to investigate the effects of overweight and obesity on glomerular filtration rate (GFR) and the relationship between body mass index (BMI) and other risk factors for CKD.Methods: This is a cross-sectional study on 627 patients admitted in a Nephrology Department between January 2007 - December 2011. Patients were divided according to eGFR in a CKD group and a non-CKD group. Patients were divided based on BMI in: normal (<25 kg/m2), overweight (≥ 25 kg/m2 and ≤30 kg/m2) and obese (>30 kg/m2). Demographical, clinical and laboratory data (serum creatinine, lipid parameters, etc) were used for the statistical analysis. The relationship between BMI (as a marker of obesity and overweight), glomerular filtration rate and other possible risk factors for chronic kidney disease was studied.Results: 43.70% patients were obese and 33.17% overweight. CKD prevalence was 58.69%. Logistic regression analysis showed that systolic blood pressure was the main determinant of CKD in our patients.Conclusion: Lack of association between BMI and CKD was demonstrated in our study.


2021 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Slamet

Obesity occurs due to excessive fat deposits in the body, one of which is a poor diet. The relationship between overweight and chronic kidney disease (CKD) is mediated through several mechanisms of adiponectin, leptin, and resistin, the development of inflammation, oxidative stress, abnormal lipid metabolism, and activation of the renin-angiotensin-aldosterone system. The purpose of this study was to determine the relationship between body mass index and estimated glomerular filtration rate in overweight students at the Health Analyst Department of Pontianak Health Polytechnic. The research design used was cross-sectional. This research was conducted on May 14-18, 2018. The population is a student health analyst. With the criteria for students from the 2015 and 2016 batches who are still active, BMI 23-29.9 Kg/m² and aged 18 to 22 years, totaling 37 respondents. The sampling technique used is total sampling. Performed include measurements of BMI, serum creatinine Jaffe method, fixed time and ELFG Cokroft-Gault formula. The results obtained using the Kendall's tau test showed that the p value (0.906) was greater than (0.05) meaning that there was no relationship between body mass index and estimated glomerular filtration rate in overweight students at the Health Analyst Department of Pontianak Health Polytechnic.


2008 ◽  
Vol 31 (8) ◽  
pp. 1559-1564 ◽  
Author(s):  
Ryuichi KAWAMOTO ◽  
Katsuhiko KOHARA ◽  
Yasuharu TABARA ◽  
Tetsuro MIKI ◽  
Nobuyuki OHTSUKA ◽  
...  

HYPERTENSION ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 5-16
Author(s):  
O.L. Rekovets ◽  
Yu.M. Sirenko ◽  
O.O. Torbas ◽  
S.M. Kushnir ◽  
H.F. Prymak ◽  
...  

Background. Identification of risk factors and preliminary assessment of overall cardiovascular risk in patients with hypertension is the most important task in clinical practice. Most patients, in addition to high blood pressure (BP), have other cardiovascular risk factors that aggravate each other, leading to an increase in overall cardiovascular risk. One of the cardiovascular risk factors is an increased arterial stiffness. Arterial stiffness is evaluated using pulse wave velocity (PWV). The other independent risk factor for cardiovascular diseases is elevated level of total homocysteine in the blood. The purpose was to evaluate the relationship between hyperhomocysteinemia (HHc) and vascular stiffness in patients with hypertension. Materials and methods. Our research was carried out as a part of the ХІПСТЕР trial in Ukraine. The study included 40 patients with hypertension stage 1 and 2 (average office systolic (SBP)/diasto-lic blood pressure (DBP) was 155.88/92.60 ± 1.63/1.43 mmHg, heart rate — 71.40 ± 1.29 bpm). The average age of the patients was 55.85 ± 2.09 (26–74) years. Individuals with homocysteine levels ≥ 10 μmol/l were referred to as those with HHc (H-type hypertension). Arterial stiffness was determined by PWV. Results. We found that at the beginning of the study, 75 % of patients (30 individuals with mild and moderate hypertension) had H-type hypertension with an increased level of homocysteine. Patients with H-type hypertension (HHc) and hypertension without HHc did not differ in terms of age, duration of hypertension. At the same time, patients with H-type hypertension had higher body weight and body mass index. Office SBP in patients with H-type hypertension at baseline and after 6 months of treatment was higher compared to patients without HHc (156.45 ± 1.04 mmHg and 152.55 ±1.41 mmHg (p < 0.05) at baseline vs 130.65 ± 0.96 mmHg and 126.97 ± 1.08 mmHg (p < 0.05) in 6 months). At the beginning of the study, body mass index was 30.72 ± 0.39 kg/m2 in patients with H-type hypertension vs 28.34 ± 0.69 kg/m2 in those without HHc (p < 0.05). Patients with H-type hypertension less often achieved target blood pressure levels during treatment and initially had higher blood pressure values. Individuals with H-type hypertension compared to patients without HHc had a more severe insulin resistance (according to the homeostatic model assessment), lower glomerular filtration rate, both at baseline and by the end of treatment. According to ambulatory blood pressure monitoring data, before the start of treatment, patients with H-type hypertension compared to those with hypertension without HHc had a significantly higher SBP level. After regression analysis, homocysteine level was associated with PWVel, regardless of the degree of BP reduction (PWVel (6 months), m/s, b = 0.307, P = 0.001). Conclusions. Male gender, body mass index, glomerular filtration rate, blood glucose, office and central blood pressure were associated with elevated serum homocysteine levels.


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