Obesity and Albuminuria in Patients with Chronic Renal Disease and Hypertension as a Comorbidity: The Optimum Body Mass Index

Abstract

Background: Obesity was associated with a greater risk for development of Chronic Kidney Disease (CKD) among subjects with and without hypertension, diabetes or cardiovascular disease. We aimed to consider the association between obesity and albuminuria in patients with CKD according to Estimated Glomerular Filtration Rate (e-GFR) and demonstrated hypertension. We also aimed to observe the optimum Body Mass Index (BMI) in this population. Methods: One hundred-thirty-three overweight and/or obese subjects with manifested hypertension were participated and they were matched to forty-three hypertensive control subjects with a normal body weight. Our participants were classified in both eGFR and albuminuria categories according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria. The obesity was defined as a high BMI (≥25 Kg/m2 as overweight and/or ≥30 Kg/m2 as obese) and the central obesity as a high waist circumference (WC) (≥94 cm in males and ≥80 cm in females). Results: The most of subjects with a lean/normal BMI did not have albuminuria (x2=24.2, p=0.001) and the most of those with a high BMI, but with a normal WC did not have albuminuria (x2=39.7, p=0.001). The high WC was found to be a main risk factor for albuminuria adjusting to confounders. Conclusions: The central obesity was shown to be the most important factor for albuminuria in patients with classified CKD rather than a high BMI independently on hypertension. The optimum BMI seems to be in the normal range for these patients similarly to the general population.