Excess weight as a risk factor for kidney failure

Abstract

The increasing incidence of end-stage renal disease and the epidemic of obesity are major public health problems. We review recent epidemiological evidence that excess weight is an important risk factor for chronic kidney disease and end-stage renal disease. A cohort study of over 300 000 adults and 8 million years of follow-up determined that elevated BMI was a significant risk factor for end-stage renal disease. This relationship was evident starting at a BMI of 25 kg/m and persisted after adjustment for hypertension and diabetes. A population-based case-control study showed that a BMI of at least 25 kg/m at age 20 was significantly associated with development of advanced chronic kidney disease. This was true even among those without diabetes or hypertension. Excess weight is a common, strong and modifiable risk factor for chronic kidney disease and end-stage renal disease. Even individuals who are not overtly obese are at risk. Excess weight contributes to chronic kidney disease and end-stage renal disease over and above its role in hypertension and diabetes. Weight loss may represent a novel intervention to reduce risk of chronic kidney disease development and progression.