Abstract: TH-PO1056
Waist Circumference and Kidney Outcomes in a Nationally Representative Patient Cohort
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Mathew, Roy O., Loma Linda VA Health Care System, Loma Linda, California, United States
- Tuttle, Katherine R., Providence Inland Northwest Health, Spokane, Washington, United States
- Neeland, Ian J., University Hospitals Health System, Cleveland, Ohio, United States
- Ndumele, Chiadi E., Johns Hopkins Medicine, Baltimore, Maryland, United States
- Khan, Sadiya, Northwestern University, Evanston, Illinois, United States
- Powell-Wiley, Tiffany, National Institutes of Health, Bethesda, Maryland, United States
- Browne, Courtney, Loma Linda University, Loma Linda, California, United States
- Murthy, Nikitha, Loma Linda University, Loma Linda, California, United States
- Sanchez, Alyssa, Loma Linda University, Loma Linda, California, United States
- Rangaswami, Janani, Washington DC VA Medical Center, Washington, District of Columbia, United States
Background
Inflammation and protein energy wasting are important when interpreting the body mass index (BMI) and mortality relationship. Waist circumference (WC)has a more predictable relationship with outcomes including in chronic kidney disease (CKD), but the current evidence relies on standardized, research setting, measurements. The reliability of routine measurements of WC from the clinical setting has not been adequately evaluated in the CKD population.
Methods
Loma Linda VA approved this project. The national Veterans Health Administration (VHA) dataset was queried for WC , recorded in inches; values < 12.5 inches or > 65 inches were excluded. The cohort was evaluated across tertiles of WC (1: <34; 2: 45- <41, 3: >= 41); BMI was categorized into quintiles. WC, BMI and other clinical variables were evaluated for relationship with all-cause mortality; and renal outcome (renal death or new diagnosis of end stage kidney disease requiring dialysis) in a competing risk framework with all-cause mortality. Weibull accelerated failure time distribution was utilized for the mortality regression due to violations of proportionality for WC and other adjustment variables. A 2-sided p-value <0.05 was considered significant.
Results
There was a total of 44808 patients with values for WC, BMI, and estimated glomerular filtration rate (eGFR). Across tertiles of WC, age was similar (mean age 61 years; 60.5 in WC1 and 62.5 in WC3). The overall population was predominantly male, but there was a significantly greater proportion of females in the WC1 tertile 11.1% vs. 2.6% in WC3; p < 0.001 across WC tertiles. For the renal failure outcome, only WC demonstrated significant direct positive relationship with renal death or new onset kidney failure (hazard ratio 1.016, p = 0.01). A paradoxical relationship with mortality was evident for BMI quintiles, but not for WC (regression estimate 1.11 for the fifth BMI quintile as compared to the first quintile, p<0.001 – positive values suggesting longer failure time; regression estimate 0.514 for WC1 versus WC3 p = 0.012).
Conclusion
Despite lack of standardized measurements from nationally representative clinical data, WC has consistent relationships with mortality and renal failure outcomes, whereas BMI has a paradoxical relationship with mortality.