Kidney Week

Abstract: FR-PO1095

Beyond the Scale: Divergent Patterns of Body Composition and Functional Change in Adults with Obesity and ESKD: A Latent Class Analysis

Session Information

• Health Maintenance, Nutrition, and Metabolism
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Harhay, Meera Nair, Drexel University, Philadelphia, Pennsylvania, United States

Meera Nair Harhay, MD, MS, FASN

• Stott, Dahlia, Drexel University, Philadelphia, Pennsylvania, United States

Dahlia Stott

• Gunen, Bengucan, Drexel University, Philadelphia, Pennsylvania, United States

Bengucan Gunen, MPH

• Doyle, Alden Michael, University of Virginia, Charlottesville, Virginia, United States

Alden Michael Doyle, MD, MSc, MPH

• Cobb, Jason, Emory University, Atlanta, Georgia, United States

Jason Cobb, MD

• Milliron, Brandy-Joe, Drexel University, Philadelphia, Pennsylvania, United States

Brandy-Joe Milliron, PhD

• Klassen, Ann Carroll, Drexel University, Philadelphia, Pennsylvania, United States

Ann Carroll Klassen, PhD

• Robinson, Lucy, Drexel University, Philadelphia, Pennsylvania, United States

Lucy Robinson, PhD

Background

Adults with ESKD and obesity exhibit diverse body composition and functional trajectories that aren't captured by weight change alone. This heterogeneity may complicate obesity treatment assessment. This study aimed to identify distinct patterns of anthropometric and functional changes over 3 months using latent class analysis.

Methods

Participants with obesity and ESKD attempting weight loss (N=44, mean age 57.7±12.4 years, 50% female, 93.2% Black, mean BMI 41.3±11.5 kg/m²) were assessed at baseline and 3-months. Measurements included weight, grip strength, 8 feet gait speed, and waist, midarm and thigh circumference. A multivariate Gaussian mixture model identified latent classes. Models with 1-5 classes were evaluated. Bayesian Information Criterion determined optimal model fit.

Results

Three classes resulted in the optimal model (Figure). Class 1 (n=14, 31.8%) had stable weight and gait speed with increased grip strength (0.59 kg) and decreased waist (-0.78 in), midarm (-0.99 in), and thigh circumference (-0.77 in). Class 2 (n=13, 29.5%) had weight gain (3.6%), increased waist (2.55 in), midarm (0.66 in) and thigh circumference (1.11 in), and decreased grip strength (-1.60 kg) and gait speed (0.32 s). Class 3 (n=17, 38.6%) had weight loss (-0.1%), increased grip strength (+0.08 kg), gait speed (-0.25 s), midarm (0.16 in) and waist circumference (0.58 in), and decreased thigh circumference (-0.25 in).

Conclusion

Three distinct patterns emerged in adults with ESKD and obesity: favorable body composition and functional changes without weight loss (Class 1), unfavorable changes with weight gain (Class 2), and modest weight loss with improved function (Class 3). Knowledge of body composition and functional change may provide more meaningful assessment of obesity interventions.

3-month changes in waist circumference and body weight among adults with ESKD and obesity by latent class membership.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20259035mc3s