Abstract
ObjectiveThe risk of chronic kidney disease (CKD) differs in the normal weight, overweight, and obese individuals owing to metabolic abnormality. We aimed to determine the combined effects of body mass index (BMI) and metabolic status on the risk of the prevalence and incidence of CKD.MethodsPubmed, Scopus, Web of science, and abstracts from recently relevant meetings prior to April 2016 were searched to identify eligible studies. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using a random effects model.ResultsEight cross-sectional studies and four longitudinal follow-up studies with a total of 14787 and 166718 participants were separately included in present study. Compared with metabolically healthy normal weight individuals, metabolically healthy obese individuals showed increased risk for CKD, with RR of 1.235 (95%CI: 1.027 to 1.484), while metabolically health overweight individuals still presented in a healthy pattern, RR=1.094(95%CI: 0.774 to 1.547). In addition, metabolically abnormal groups had much higher risk for CKD, with RR of 1.572 (95%CI: 1.373 to 1.801), 1.652(95%CI: 1.139 to 2.397) and 1.898(95%CI: 1.505 to 2.395) across metabolically unhealthy normal weight, overweight and obese individuals respectively.ConclusionIndividuals with abnormal metabolic status are at a significantly elevated risk for CKD, regardless of BMI. For metabolically healthy individuals, CKD risk increases with the growth of BMI, and obese persons eventually have a higher risk.
Highlights
Owing to its deadly adverse outcomes, including end-stage renal disease (ESRD) and increased cardiovascular risk, chronic kidney disease (CKD) has gradually became a major health burden worldwide [13]
Seven of eight longitudinal studies chose incidence of CKD as the terminal event, while one study examined the joint associations of body mass index (BMI) and metabolic status with risk of ESRD
There exist the biggest controversies over different outcomes in metabolically healthy obese (MHO) group of obesity individuals who have relatively normal metabolic features and metabolically abnormal with normal weight (MANW) group of metabolically unhealthy individuals whose BMI is in the normal level
Summary
Owing to its deadly adverse outcomes, including end-stage renal disease (ESRD) and increased cardiovascular risk, chronic kidney disease (CKD) has gradually became a major health burden worldwide [13]. Mounting evidence indicates that increased BMI is associated with excess all-cause mortality and cardiovascular diseases [6]. Quite a few studies reported that obesity may confer a beneficial effect on individuals with chronic diseases [7,8,9]. Final conclusion has not yet been reached www.impactjournals.com/oncotarget on such matters that if obesity itself without secondary metabolic abnormalities contributes to the development of CKD or whether the relationship between MetS and CKD differs along with weight change. The complexity of the relationship between BMI and CKD may presumably be attributed to the heterogeneity of obese phenotypes: presence or absence of concurrent metabolic abnormalities
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
