1. From this prospective cohort study, patients that were metabolically healthy and overweight or obese were associated with increased risk for chronic kidney disease (CKD) when compared to normal-weight participants.
2. Greater differences in CKD risk were observed in patients aged 40 years or older.
Evidence Rating Level: 2 (Good)
Study Rundown: Chronic kidney disease (CKD) is a precursor of end-stage renal disease and a strong risk factor for cardiovascular morbidity and mortality. Metabolic abnormalities related to obesity have been shown to be major risk factors for CKD; however, little is known regarding the relationship between CKD and body mass index (BMI) in metabolically healthy patients. This study, therefore, examined the association between categories of BMI and CKD in a large sample of metabolically healthy men and women. Compared to normal-weight participants, obese patients were associated with the greatest risk of developing CKD. Overweight patients showed the second greatest risk, while being underweight was not correlated with CKD risk. This study is limited by several factors. First, while BMI is a commonly used marker of obesity, it does not distinguish between differences in adipose tissue distribution. Additionally, changes in BMI over the course of the study were not included in calculations, nor was duration of obesity accounted for. However, overall, this study suggests that regardless of metabolic health, obesity is associated with a higher incidence of CKD.
Relevant Reading: Obesity and chronic kidney disease
In-Depth [prospective cohort]: For this study, South Korean men and women aged 18 years or older were selected from the Kangbuk Samsung Health Study cohort. Metabolic health was evaluated through a homeostasis model assessment of insulin resistance, where participants with a score lower than 2.5 and the absence of a component of metabolic syndrome were chosen for inclusion in this study. The incidence rate of CKD was standardized to account for many factors, including smoking status, alcohol intake, and baseline physical activity. The adjusted differences in 5-year cumulative incidence of CKD for obese and overweight participants were 6.7 (95%CI 3.0 to 10.4) and 3.5 (95%CI, 0.9 to 6.1) cases per 1000 persons, respectively, when compared to normal-weight participants. Furthermore, greater differences in CKD risk among BMI categories were observed in individuals aged 40 years or older. Specifically, the risk for obese patients was 19.0 (95%CI 8.7 to 29.3) cases per 1000 persons in patients aged 40 or older.
©2016 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.