Abstract P251: Association Between Different Measures of Obesity and Kidney Function Decline

Abstract

Introduction: Obesity has been related to increased risk of incident cardiovascular disease, diabetes, and mortality as well as chronic kidney disease (CKD). However, the effect of obesity on long-term kidney function and whether it differs by gender and race are not known. Hypothesis: Obesity status is associated with future decline in kidney function. Methods: Obesity was measured by baseline body mass index (BMI), waist to hip ratio (WHR), and predicted percent fat (PPF) among 14,020 White (W) and African-American (AA) men and women (M/F) in the Atherosclerosis Risk in Communities (ARIC) study who were diabetes-free, had BMI > 18.5 kg/m 2 , and had estimated glomerular filtration rate (eGFR) > 60 ml/min/1.73 m 2 at baseline. Obesity was categorized into tertiles within each race-sex group. PPF was derived using anthropometric prediction equations including information on age, race, weight, height, and waist circumference. Mixed models with random intercepts and random slopes were used to evaluate the association between baseline obesity status and eGFR trajectories (calculated from serum creatinine at 5 visits). Cox proportional hazards models were used to estimate the hazard ratios (HRs) of end-stage kidney disease (ESKD) associated with baseline obesity status. Results: At baseline, participants had a mean age of 54 years, median eGFR of 103 ml/min/1.73 m 2 , and median BMI of 27 kg/m 2 . Over 30 years follow-up, all obesity measures showed some associations with more rapid eGFR decline with PPF showing the most consistent associations across race-sex subgroups ( Table ). All obesity indicators were associated with increased risk of ESKD for all race-sex groups (p trend<0.05). For example, the HRs (95% CI) of ESKD per SD of PPF were 1.20 (1.05, 1.37) for WM, 1.54 (1.31, 1.80) for WF, 1.67 (1.45, 1.92) for AAM, and 1.62 (1.42, 1.84) for AAF. Conclusion: In summary, obesity status is a risk factor for future decline in kidney function and development of ESKD in community-dwelling adults with PPF showing some advantages over BMI and WHR.