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Abstract: FR-PO553

The Association Between Obesity and CKD in the Human Hereditary and Health in Africa Kidney Disease Research Network

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Ilori, Titilayo O., University of Arizona, Tucson, Arizona, United States
  • Osafo, Charlotte, University of Ghana Medical School, ACCRA, Ghana
  • Kumar, Shikhar, The university of arizona, Tucson, Arizona, United States
  • Parekh, Rulan S., The Hospital For Sick Children, Toronto, Ontario, Canada
  • Adu, Dwomoa, University of Ghana, Accra, Ghana
  • Gbadegesin, Rasheed A., Duke University Medical Center, Durham, North Carolina, United States
  • Ojo, Akinlolu O., University of Arizona Health Sciences, Tucson, Arizona, United States

Group or Team Name

  • H3Africa Kidney Disease Study
Background

There is very little existing data on the relationship between obesity and CKD in Africans. We estimated the prevalence of obesity among cases (eGFR<60ml/min/1.73m2) and controls (eGFR>60ml/min/1.73m2) in the Human Hereditary and Health in Africa Kidney Disease Research Network (H3A-KDRN) and determined the association between obesity (measured by body mass index (BMI) and waist circumference) and CKD.

Methods

In this case-control study, we estimated the prevalence of obesity in cases and controls using BMI >30kg/m2 and waist circumference >88cm in women and >102cm in men as definitions for obesity. Using logistic regression, we estimated crude and adjusted prevalence odds ratios and 95% confidence intervals for CKD in the entire cohort.

Results

The prevalence of obesity using BMI was 28.2% in the cases vs 21.5% in the controls (p<0.0000001) while the prevalence of obesity by waist circumference was 22.8% in cases and 26.2% in controls (p<0.01). Cases with a higher BMI were more likely to have higher eGFR (p<0.001) while controls with a higher BMI had a lower eGFR (p<0.0001). Compared to those with normal BMI, underweight individuals were 1.43 times more likely to have CKD, OR=1.43 (95% CI 1.11, 1.83). Overweight OR =0.87 (0.77,0.99) and obesity class I OR=0.81 (95% CI 0.68,0.95) were both associated with lower odds of CKD in the crude analyses. After adjusting for age, gender, country, hemoglobin and ACR underweight OR=1.61(95% CI 1.31, 1.98), overweight OR=0.85 (95% CI 0.74,0.97) and class I obesity OR=0.82 (95% CI 0.68, 0.99) remained associated with CKD. Compared to those with a normal waist circumference (80-87.9cm in women and 94-101.9cm in men), individuals with a waist circumference of <80cm in women and <94cm in men were more likely to have CKD (OR=1.24, 95% CI 1.05,1.48) in the crude and some adjusted models OR=1.20 (95% CI 1.01, 1.44). No other waist circumference categories were associated with CKD.

Conclusion

The findings in this stud mimics the risk factor paradox for obesity. Underweight individuals were more likely to have CKD but obese and overweight were less likely to have CKD. We will need further prospective studies to determine if higher BMI is protective of CKD in Africans or if these findings are reflective of reverse causality.

Funding

  • NIDDK Support