Abstract
PurposeTo examine the relationship between body mass index (BMI) and the risk of stage ≥3 chronic kidney disease (CKD) in a general Japanese population.MethodsA total of 105 611 participants aged 40–79 years who completed health checkups in Ibaraki Prefecture, Japan, and were free of CKD in 1993 were followed-up through 2006. Stage ≥3 CKD was defined by an estimated glomerular filtration rate <60 mL/min/1.73 m2 reported during at least 2 successive annual surveys or as treatment for kidney disease. Hazard ratios (HRs) for the development of stage ≥3 CKD relative to the BMI categories were calculated using the Cox proportional hazards regression model, which was adjusted for possible confounders and mediators.ResultsDuring a mean follow-up of 5 years, 19 384 participants (18.4%) developed stage ≥3 CKD. Compared to a BMI of 21.0–22.9 kg/m2, elevated multivariable-adjusted HRs were observed among men with a BMI ≥23.0 kg/m2 and women with a BMI ≥27.0 kg/m2. Significant dose-response relationships between BMI and the incidence of stage ≥3 CKD were observed in both sexes (P for trend <0.001).ConclusionsObesity was associated with the risk of developing stage ≥3 CKD among men and women.
Highlights
Chronic kidney disease (CKD) is a major public health problem
Obesity is associated with the development of many cardiovascular disease (CVD) risk factors, including type 2 diabetes mellitus,[3,4] hypertension,[5,6] dyslipidemia,[7] and chronic kidney disease (CKD).[8]
A higher body mass index (BMI) was linked with a higher estimated glomerular filtration rate (eGFR) and a higher prevalence of proteinuria in both sexes
Summary
Chronic kidney disease (CKD) is a major public health problem. Obesity is associated with the development of many cardiovascular disease (CVD) risk factors, including type 2 diabetes mellitus,[3,4] hypertension,[5,6] dyslipidemia,[7] and CKD.[8] Prospective cohort studies have revealed the longitudinal relation between body mass index (BMI) and the risk of moderate CKD. A greater baseline BMI was associated with an increased risk of stage ≥3 CKD in the Physician’s Health Study,[9] the Hypertension Detection and Follow-Up Program,[10] and the Framingham Heart Study.[11] Because treatment of long-term CKD is costly, the best approach is to reduce the incidence of stage ≥3 CKD or prevent it entirely. Examining the modifiable risk factors for stage ≥3 CKD, such as obesity, is important because of the public health implications
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