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Abstract: SA-PO831

Effect of Age and Gender on the Relation Between Body Fat Area and Kidney Outcomes in Patients with CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Osako, Kiyomi, Division of Nephrology and Hypertension, Department of Internal Medicine, St Mariannna University of Medicine, Kawasaki, Japan
  • Shibagaki, Yugo, Division of Nephrology and Hypertension, Department of Internal Medicine, St Mariannna University of Medicine, Kawasaki, Japan
  • Sakurada, Tsutomu, Division of Nephrology and Hypertension, Department of Internal Medicine, St Mariannna University of Medicine, Kawasaki, Japan
Background

Increase in body fat area has been noted as a risk factor for progression of chronic kidney disease (CKD) as well as cardiovascular disease and death. Similarly, obesity has been shown to be associated with CKD progression, but this association might be interacted with patient’s characteristics. Here, we examined obesity assessed by body fat area is related to kidney outcomes in patients with CKD with possible interaction by age and gender.

Methods

We included 367 patients who completed CKD educational program between January 2011 and February 2017. Patients were classified into four groups: male patients under 75yo, (n=164), female patients under 75yo(n=52), male patients 75yo or older(n=98), and female patients 75yo or older(n=53). Body fat area was measured at the level of the umbilicus using an CT-image analysis system. Kidney outcomes was defined as initiation of renal replacement therapy or incidence of 50% reduction in estimated glomerular filtration rate.

Results

The overall mean age of the patients was 73.0 (65.0-78.0) years old, of whom 262 patients (71.4%) were male, and the median estimated glomerular filtration rate based on plasma cystatin C (eGFRcys) was 26.9 mL / min / 1.73 m2. During the observation period [median 1.7 year (0.7-3.5)], 187 patients reached kidney outcomes. In both univariate and multivariate Cox regression analysis, VFA and SFA were not associated with increased kidney outcome in overall population. However, in males under 75yo, multivariate Cox regression analysis showed SFA but not VFA as significant risk for kidney outcomes (SFA: HR 1.06, 95% CI: 1.02-1.11). In turn, VFA but not SFA was significantly associated with decreased kidney risk in female under 75 yo (VFA: HR 0.83, 95% CI: 0.71-0.97). Moreover, in patients 75yo or older in both sex, multivariate Cox regression analysis failed to show the significant association with kidney outcomes in both VFA and SFA.

Conclusion

Obesity as assessed by body fat area was not a significant risk for CKD progression in very old patients with CKD. In younger patients with CKD, high SFA in males was a significant risk factor for CKD progression, whereas high VFA in females was a significant renoprotective factor. When we consider obesity as a potential risk for CKD progression, we need to consider age and gender.