Abstract: SA-PO355

Association between Obesity and Prevalence of CKD in Patients with Type 2 Diabetes Mellitus and/or Arterial Hypertension

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Cortes-Sanabria, Laura, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Ayala cortes, Rafael Adalid, Unidad de Investigación Médica en Enfermedades Renales, Guadalajara, Jalisco, Mexico
  • Calderon Garcia, Clementina Elizabeth, Mexican Social Security Institute, Guadalajara, Mexico
  • Rojas-Campos, Enrique, INSTITUTO MEXICANO DEL SEGURO SOCIAL, GUADALAJARA, Mexico
  • Cueto-Manzano, Alfonso M., None, Zapopan, Jalisco, Mexico
Background

Obesity, directly or through several comorbidities such as diabetes mellitus, high blood pressure, metabolic syndrome or cardiovascular disease, increase the risk for development and progression of CKD. It is noteworthy, however, the lack of information in this regard in settings with high prevalence of risk factors for CKD, such as Latin America, and particularly Mexico. Aim: To determine the association between obesity and CKD in patients recently diagnosed with only type 2 diabetes mellitus (DM2), arterial hypertension (AHT) without DM2, and DM2+AHT.

Methods

Cross-sectional study. Patients with transient causes of albuminuria were excluded. All patients had a medical history and clinical examination; glomerular filtration rate was estimated (eGFR) by the CKD-EPI formula and albuminuria/creatininuria was determined by nephelometry. Obesity was classified according with WHO criteria and CKD according with KDIGO guidelines.

Results

2123 patients (DM2 = n 676; DM2+AHT = n 877, and AHT = n 570) were studied. Mean age was 60±12 yrs, 62% women, DM2 vintage 9 (4-15) yrs and AHT vintage 7 (3-14) yrs. Prevalence of obesity was lower in DM2 (35%) compared to DM2+AHT (45%) and AHT (46%) (p<0.0001). Comparing patients with obesity vs normal weight, prevalence of CKD were lower in DM2 (31% vs 42%, respectively, p= 0.01), but it was higher in DM2+AHT (38% vs 20%, p=0.02) and AHT (40% vs 16%, p= 0.01) patients. Results of multivariate analysis are shown in the Table

Conclusion

Frequency of obesity was significantly higher in patients with DM2+AHT. The risk to present CKD is higher in DM2+AHT than in isolated DM2 or AHT. It is necessary to advice for modification of negative lifestyle habits, especially in patients with diabetes and hypertension in order to prevent development and progression of kidney damage.

Logistic regression model of variables predicting CKD
 DM2  DM2+AHT  AHT  
VariableORCI 95%pORCI 95%pORCI 95%p
Age0,970,95-0,98<0,010,970,95-0,98<0,010,940,92-0,97<0,01
Male gender1,561,1-2,22<0,031,751,29-2,43<0,011,671,05-2,670,06
DM Vintage1,081,05-1,09<0.0011,071,05-1,09<0,001---------
Systolic blood pressure0,990,98-1,000.090,990,98-1,010,860,990,98-0,990,05
Overweight/Obesity1,51,0-2,610,091,361,03-1,80,061,130,59-2,140,07