Kidney Week

Abstract: SA-PO0490

Real-World Waist Circumference and Kidney Outcomes: Observational Analysis of US Veterans Affairs Data

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Mathew, Roy O., VA Loma Linda Healthcare System, Loma Linda, California, United States

Roy O. Mathew, MD, FASN

• Fung, Enrica, Stanford Medicine, Stanford, California, United States

Enrica Fung, MD, MPH, FASN

• Hong, Annie V., VA Loma Linda Healthcare System, Loma Linda, California, United States

Annie V. Hong, MD

• Sanchez, Alyssa, Loma Linda University Health, Loma Linda, California, United States

Alyssa Sanchez, DO

• Infante, Sergio, Loma Linda University Health, Loma Linda, California, United States

Sergio Infante, MD, FASN

• Rhee, Connie, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States

Connie Rhee, MD, MS

• Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

• Abdi Pour, Amir, Loma Linda University Health, Loma Linda, California, United States

Amir Abdi Pour, MD, FASN

• Rangaswami, Janani, Washington DC VA Medical Center, Washington, District of Columbia, United States

Janani Rangaswami, MD

Background

Rigorously collected WC in the research setting had a linear relationship with the composite outcome of 40% estimated glomerular filtration rate (eGFR), end stage kidney disease (ESKD) or eGFR < 10 ml/min/1.73m².(Chang AR BMJ 2019 Jan 10; 364:k5301). It is unclear whether routinely collected WC in clinical practice has similar relationships with kidney outcomes.

Methods

Loma Linda VA IRB provided expedited approval. This was a retrospective cohort study. Data was taken from the National US Veterans Health Administration (VHA) database, including 20,113 individuals with available WC and eGFR measured at baseline (WC date) and 5 years (5yrs) from baseline. Participants were stratified by WC tertiles (≤34, >34–40, > 41 inches[in]; minimum acceptable WC was 23 in. and maximum was 65 in.). The primary outcome was the odds of 30% or 50% decline in eGFR at 5yrs from baseline using logistic regression, adjusted for baseline body mass index, eGFR, age, diabetes status, and race/ethnicity.

Results

Average age of the population was 61 years, 23% were of Black race, 91% male, 83% with HTN and 51% with diabetes. There was a greater proportion of White individuals, and individuals with diabetes and hypertension in the higher WC group, and lower proportion of females in the higher WC group (2.5% in the highest WC group versus 8.5% in the lowest WC; p for trend < 0.001). eGFR decline over 5 yrs was faster in those in the highest WC group (Figure plot A), as well as higher in patients with diabetes (Figure plot B). Multivariable adjusted odds ratio for 50% decline or greater in eGFR at 5yrs was 1.25 (p = 0.2) for the 2^nd WC group, and 1.66 (p = 0.004) for the highest WC group.

Conclusion

WC obtained in the routine clinical setting, likely with variable technique across sites, demonstrated a graded positive association with kidney function decline. WC should be routinely incorporated into nephrology practice for risk prediction.