Kidney Week

Abstract: TH-PO813

Underweight Status and Development of ESKD: A Nationwide Population-Based Study

Session Information

• Health Maintenance, Nutrition, Metabolism
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance‚ Nutrition‚ and Metabolism

• 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

• Kim, Chang Seong, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Chang Seong Kim,

• Oh, Tae ryom, Chonnam National University Hospital, Gwangju, Korea (the Republic of)

Tae ryom Oh,

• Suh, Sang Heon, Chonnam National University Hospital, Gwangju, Korea (the Republic of)

Sang Heon Suh,

• Choi, Hong sang, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Hong sang Choi,

• Bae, Eun Hui, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Eun Hui Bae,

• Ma, Seong Kwon, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Seong Kwon Ma,

• Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Soo Wan Kim,

Background

An underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether an underweight status is associated with an increased risk of developing end-stage kidney disease (ESKD) is unknown.

Methods

A total of 9,845,420 participants aged ≥ 20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and were analyzed in this study. Individuals with underweight (body mass index [BMI] < 18.5 kg/m²) and obesity (BMI ≥ 25 kg/m²) were categorized according to the World Health Organization recommendations for Asian populations.

Results

During a mean follow-up period of 9.2 ± 1.1 years, 26,406 participants were diagnosed with ESKD. After fully adjusting for other potential predictors of ESKD, the severe underweight group (BMI < 16.5 kg/m²) had a significantly higher risk of ESKD than the reference (normal) weight group (adjusted hazard ratio [HR], 1.531; 95% confidence interval [CI], 1.243–1.884), whereas the obesity group had a lower risk of ESKD (adjusted HR, 0.661; 95% CI, 0.642–0.681). Compared with the reference BMI group (BMI 24–25 kg/m²), the adjusted HRs for ESKD increased as BMI decreased by 1 kg/m². In the sensitivity analysis, sustained underweight or progression to an underweight status over two repeated health checkups had a higher HR for ESKD, even after fully adjusting for other potential predictors.

Conclusion

An underweight status is associated with an increased risk of ESKD, and this association gradually becomes stronger as BMI decreases.