Kidney Week

Abstract: SA-PO829

Noninvasive Measures of Visceral Adiposity and Risk of Kidney Function Decline

Session Information

• Health Maintenance, Nutrition, Metabolism - II
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1300 Health Maintenance, Nutrition, and Metabolism

Authors

• Kumar, Ujjala, UCSD, San Diego, California, United States

Ujjala Kumar,

• Gutierrez, Orlando M., UAB School of Medicine, Birmingham, Alabama, United States

Orlando M. Gutierrez,

• Kramer, Holly J., Loyola University Medical Center, Maywood, Illinois, United States

Holly J. Kramer,

• Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States

Mark J. Sarnak,

• Ix, Joachim H., UCSD, San Diego, California, United States

Joachim H. Ix,

• Katz, Ronit, University of Washington, Seattle, Washington, United States

Ronit Katz,

• Judd, Suzanne E., UAB School of Medicine, Birmingham, Alabama, United States

Suzanne E. Judd,

• Cushman, Mary, University of Vermont, Colchester, Vermont, United States

Mary Cushman,

• Garimella, Pranav S., UCSD, San Diego, California, United States

Pranav S. Garimella,

Background

Measures of visceral obesity are better markers of adverse outcomes than body mass index (BMI) and waist circumference (WC). Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity calculated by using BMI, WC and serum lipids. We hypothesized that LAP and VAI will be associated with adverse kidney outcomes independent of traditional risk factors.

Methods

Using data from Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, we evaluated the association of LAP, VAI, BMI and WC with (a) 1127 cases of incident CKD, defined as reaching an eGFR <60ml/min/1.73m² with at least 25% decline between visit 1 and 2; (b) 1452 cases of >30% eGFR decline using logistic regression; and (c) 353 cases of incident ESRD using Cox regression.

Results

Mean age was 65 years, 54% were women, and 41% were African American. The median time between visit 1 and 2 was 9.4 years. After adjusting for confounders, the top quartiles of VAI, LAP, BMI and WC were associated with higher odds of incident CKD and progressive eGFR decline compared to bottom quartiles.VAI and LAP were associated with an increased risk of ESRD after demographic and risk factor adjustment (HR 1.94; 95% CI, 1.37 to 2.76) but this association was no longer significant after adjusting for baseline eGFR and albuminuria.

Conclusion

Adiposity assessed by measures of generalized and visceral obesity is associated with higher risk of incident CKD and eGFR decline. VAI and LAP are not more strongly associated with CKD and eGFR decline compared to BMI and WC. However, for incident ESRD, VAI and LAP may be valuable for providing useful information beyond BMI and WC (in the models that do not include eGFR/ACR).