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Kidney Week

Abstract: PO1570

Overweight and Obesity Are Predictors of Pain in the HALT-PKD Studies

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Authors

  • Wang, Wei, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States
  • You, Zhiying, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States
  • Gitomer, Berenice Y., University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States
  • Brosnahan, Godela M., University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States
  • Harris, Peter C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Abebe, Kaleab, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Steinman, Theodore I., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Yu, Alan S.L., University of Kansas Medical Center, Kansas City, Kansas, United States
  • Perrone, Ronald D., Tufts Medical Center, Boston, Massachusetts, United States
  • Braun, William E., Cleveland Clinic, Cleveland, Ohio, United States
  • Chapman, Arlene B., UChicago Medicine, Chicago, Illinois, United States
  • Chonchol, Michel, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States
  • Nowak, Kristen L., University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States

Group or Team Name

  • HALT-PKD Study
Background

Pain is a frequent complication of autosomal dominant polycystic kidney disease (ADPKD) and includes back and abdominal pain. Level of pain was previously found to be unrelated to kidney size in participants in the 5-yr HALT-PKD studies. We hypothesized that overweight and obesity would be independently associated with greater self-reported back, abdominal, and radicular pain at baseline and that weight loss would be associated with reduced pain over the follow-up period.

Methods

835 individuals with ADPKD who participated in the 5-yr HALT-PKD study A or B were included in a cross-sectional analysis. The association of baseline BMI with pain was evaluated using multivariable ordinal logistic regression (likert-scale responses). In a longitudinal analysis, the association of annual change in BMI as a time-varying predictor with annual change in pain was evaluated using a generalized estimating equation analysis.

Results

Participants were 43±10 years old and baseline estimated glomerular filtration rate (eGFR) was 71±26 ml/min/1.73m2. Back, abdominal, and radicular pain were reported more frequently in individuals with overweight/obesity (p<0.05). After adjustment for demographics, exercise, pain medications, eGFR, and mutation class, overweight/obesity were associated with increased odds of greater back pain and radicular pain, but not abdominal pain. Associations remained similar after further adjustment for baseline height-adjusted kidney and liver volume (Study A only; n=436); back pain: overweight OR: 1.66 [1.02, 2.68], obese OR: 1.77 [1.03, 3.03]; radicular pain: overweight: 2.28 [1.13, 4.60], obese OR: 2.68 [1.25, 5.76]. Longitudinally (n=823), weight loss (annual BMI decrease >3%) was associated with decreased odds of worsening back pain (OR: 0.87 [0.76, 1.00]) over time vs. weight gain (annual BMI increase >3%).

Conclusion

In early- and late-stage participants in the HALT-PKD studies, overweight and obesity were associated with greater back and radicular pain, independent of total kidney/liver volume. Weight loss was associated with reduced risk of worsening back pain, thus may be an effective strategy to reduce pain symptoms in individuals with ADPKD.

Funding

  • NIDDK Support