Obesity in Glomerular Disease
October 25, 2018 | 10:00 AM - 12:00 PM
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Obesity in Glomerular Disease
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention
- Shah, Paras P., Cohen Children's Medical Center, Fremont, California, United States
- Meyers, Kevin E.C., The Children Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Brady, Tammy M., Johns Hopkins University, Baltimore, Maryland, United States
- Gibson, Keisha L., University of North Carolina Kidney Center, Chapel Hill, North Carolina, United States
- Srivastava, Tarak, Childrens's Mercy Hospital, Kansas City, Missouri, United States
- Sethna, Christine B., Cohen Children's Medical Center of NY, New Hyde Park, New York, United States
Paras P. Shah,
Kevin E.C. Meyers,
Tammy M. Brady,
Keisha L. Gibson,
Christine B. Sethna,
Group or Team Name
- NEPTUNE Cardiovascular Working Group
Obesity is a risk factor for cardiovascular disease (CVD) and contributes to the development and progression of kidney disease. The impact of obesity on glomerular disease has not been well-described.
Longitudinal data were from 488 participants in the Nephrotic Syndrome Study Network (NEPTUNE). Obesity was defined as body mass index (BMI) ≥30 kg/m2 for adults and ≥95% for children. Blood pressure (BP), lipids, complete remission ever (urine protein:creatinine [UPC] <0.3) and composite endpoint (ESRD or 40% decrease in eGFR) were compared in obese vs. non-obese. Generalized estimating equations examined obesity with outcomes, adjusted for age, sex, black race, glomerular diagnosis, follow-up, edema, UPC, eGFR, steroids, calcineurin inhibitors (CNI), renin angiotensin blockade (RAAS), SBP and obesityxedema.
322 adults (46.5±16 yr, 62% M, 21% black) and 166 children (9.6±5 yr, 57% M, 42% black) with baseline median eGFR 83 (IQR 53,105) ml/min/1.73m2 and UPC 2(IQR 0.7,4.3) were evaluated. 43% of adults and 38% of children were obese (35% and 34% in non-edematous, respectively). The proportion with obesity did not change during mean 35±20 months of follow-up (Q=11.9, p=0.29). See Table 1. In adjusted models, obesity was associated with hypertension (HTN) (OR1.61 CI 1.14-2.28), greater SBP (β5.73 CI 0.15-11.3) and lower HDL (β-8.1 CI-12.17– -4.03) in adults. For children, obese had greater DBP index ( 0.03 CI 0.001– 0.07 ), greater triglycerides (β29.3 CI 1.91–56.7) and lower HDL (β-6.87 CI -12.07- -1.68), as well as increased odds of HTN (OR2.14 CI 1.26–3.65), dyslipidemia (OR1.61 CI 1.04–2.5) and high HDL (OR2.24 CI 1.31–3.81) compared with non-obese. Obesity was not associated with renal outcomes.
In NEPTUNE, obesity is common and associated with CVD risk when compared to non-obese participants.
- NIDDK Support