Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes
Obesity-related nephropathy is associated with renal function progression. However, some studies have associated a high body mass index (BMI) with improved renal outcomes—this is referred to as the obesity paradox for renal outcomes, especially in relation to advanced chronic kidney disease (CKD). C...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/10/2787 |
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| author | Chi-Chih Hung Pei-Hua Yu Sheng-Wen Niu I-Ching Kuo Jia-Jung Lee Feng-Ching Shen Jer-Ming Chang Shang-Jyh Hwang |
| author_facet | Chi-Chih Hung Pei-Hua Yu Sheng-Wen Niu I-Ching Kuo Jia-Jung Lee Feng-Ching Shen Jer-Ming Chang Shang-Jyh Hwang |
| author_sort | Chi-Chih Hung |
| collection | DOAJ |
| description | Obesity-related nephropathy is associated with renal function progression. However, some studies have associated a high body mass index (BMI) with improved renal outcomes—this is referred to as the obesity paradox for renal outcomes, especially in relation to advanced chronic kidney disease (CKD). Central obesity can explain the obesity paradox in all-cause mortality. However, whether obesity or central obesity is associated with renal outcomes (renal replacement therapy or a 50% decline in the estimated glomerular filtration rate) in patients with advanced CKD remains unclear. Our study included 3605 Asian patients with CKD stages 1–5 divided into six groups according to their BMI (between 15 and 35 kg/m<sup>2</sup>). Through linear regression, BMI was positively associated with hemoglobin and albumin at CKD stages 4 and 5. In the competing risk Cox regression model, a high BMI (27.5–35 kg/m<sup>2</sup>) was associated with renal outcomes at CKD stages 1–3, but not stages 4 and 5. A high BMI was associated with renal outcomes in patients with hemoglobin ≥11 g/dL, but not <11 g/dL. A high waist-to-hip ratio was not associated with renal outcomes. We conclude that the CKD stage and anemia may explain the obesity paradox in renal outcomes in patients with CKD. |
| first_indexed | 2024-03-10T03:40:29Z |
| format | Article |
| id | doaj.art-617b308a17ff42aa8aaa7e6427a6c3f9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:40:29Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-617b308a17ff42aa8aaa7e6427a6c3f92023-11-23T11:34:49ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011110278710.3390/jcm11102787Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal OutcomesChi-Chih Hung0Pei-Hua Yu1Sheng-Wen Niu2I-Ching Kuo3Jia-Jung Lee4Feng-Ching Shen5Jer-Ming Chang6Shang-Jyh Hwang7Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80145, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80145, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanObesity-related nephropathy is associated with renal function progression. However, some studies have associated a high body mass index (BMI) with improved renal outcomes—this is referred to as the obesity paradox for renal outcomes, especially in relation to advanced chronic kidney disease (CKD). Central obesity can explain the obesity paradox in all-cause mortality. However, whether obesity or central obesity is associated with renal outcomes (renal replacement therapy or a 50% decline in the estimated glomerular filtration rate) in patients with advanced CKD remains unclear. Our study included 3605 Asian patients with CKD stages 1–5 divided into six groups according to their BMI (between 15 and 35 kg/m<sup>2</sup>). Through linear regression, BMI was positively associated with hemoglobin and albumin at CKD stages 4 and 5. In the competing risk Cox regression model, a high BMI (27.5–35 kg/m<sup>2</sup>) was associated with renal outcomes at CKD stages 1–3, but not stages 4 and 5. A high BMI was associated with renal outcomes in patients with hemoglobin ≥11 g/dL, but not <11 g/dL. A high waist-to-hip ratio was not associated with renal outcomes. We conclude that the CKD stage and anemia may explain the obesity paradox in renal outcomes in patients with CKD.https://www.mdpi.com/2077-0383/11/10/2787obesity paradoxrenal outcomechronic kidney diseasebody mass indexcentral obesitywaist-to-hip ratio |
| spellingShingle | Chi-Chih Hung Pei-Hua Yu Sheng-Wen Niu I-Ching Kuo Jia-Jung Lee Feng-Ching Shen Jer-Ming Chang Shang-Jyh Hwang Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes Journal of Clinical Medicine obesity paradox renal outcome chronic kidney disease body mass index central obesity waist-to-hip ratio |
| title | Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes |
| title_full | Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes |
| title_fullStr | Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes |
| title_full_unstemmed | Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes |
| title_short | Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes |
| title_sort | association between body mass index and renal outcomes modified by chronic kidney disease and anemia the obesity paradox for renal outcomes |
| topic | obesity paradox renal outcome chronic kidney disease body mass index central obesity waist-to-hip ratio |
| url | https://www.mdpi.com/2077-0383/11/10/2787 |
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