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Abstract: SA-PO442

Body Mass Index, Waist Circumference, and Risk of Kidney Function Decline in a Global Consortium

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Author

  • Chang, Alex R., CKD Prognosis Consortium, Baltimore, Maryland, United States
Background

Limited data exist on the association between body mass index (BMI) or waist circumference (WC) with kidney function decline.

Methods

We performed collaborative meta-analyses to examine the association between BMI and WC with kidney function decline (ESKD or eGFR decline ≥40%) in 26 general population (GP) (n=712748) cohorts, of which 17 (n=238210) cohorts had WC data. Secondary meta-analyses were done in 12 CKD cohorts (n=22587), and in 6 high-risk population cohorts (n=135054). References were set at BMI 25 kg/m2 and sex-specific WC values of 92 cm (men) and 78 cm (women).

Results

In GP cohorts, mean values for BMI, eGFR, and sex-specific WC were 27.8 (6.3) kg/m2, 90.1 (22.5) ml/min/1.73m2, and 92.2 (11.5) cm for men and 84.3 (13.2) cm for women, respectively. Within the 26 cohorts, 26,424 individuals developed kidney function decline over a mean follow-up of 6.9 (4.2) years. In analyses adjusted for age, sex, race, and current smoking, a BMI of 30 kg/m2 vs. 25 kg/m2 was associated with a hazard ratio (HR) of 1.20 (95% CI: 1.14-1.26) for kidney function decline (Figure). For the same outcome, WHO-recommended cut-points of waist circumference of 102 cm (men) and 88 cm (women) were associated with an HR of 1.15 (95% CI: 0.99-1.34) relative to the sex-specific references. The relationship between BMI and kidney function decline did not significantly differ by age, gender, diabetes, or baseline eGFR category. Associations were attenuated in high-risk and CKD cohorts, and when models were additionally adjusted for baseline diabetes, cardiovascular disease, hypertension, and eGFR.

Conclusion

Elevated BMI and WC are risk factors for ESKD and eGFR decline ≥40% in individuals with normal and reduced eGFR.

Funding

  • NIDDK Support