Kidney Week

Abstract: TH-PO479

Obesity in Glomerular Disease

Session Information

• 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

Authors

• Shah, Paras P., Cohen Children's Medical Center, Fremont, California, United States

Paras P. Shah,

• Meyers, Kevin E.C., The Children Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States

Kevin E.C. Meyers,

• Brady, Tammy M., Johns Hopkins University, Baltimore, Maryland, United States

Tammy M. Brady,

• Gibson, Keisha L., University of North Carolina Kidney Center, Chapel Hill, North Carolina, United States

Keisha L. Gibson,

• Srivastava, Tarak, Childrens's Mercy Hospital, Kansas City, Missouri, United States

Tarak Srivastava,

• Sethna, Christine B., Cohen Children's Medical Center of NY, New Hyde Park, New York, United States

Christine B. Sethna,

Group or Team Name

• NEPTUNE Cardiovascular Working Group

Background

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.

Methods

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.

Results

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.

Conclusion

In NEPTUNE, obesity is common and associated with CVD risk when compared to non-obese participants.

Funding

• NIDDK Support