Low Body Mass Index Is A Cardiovascular Risk Without Progression Of Chronic Kidney Disease

The paradoxical risk of body mass index (BMI) on mortality is known in chronic kidney disease (CKD) and dialysis populations. However, study of cardiovascular disease (CVD) risk in CKD including underweight has been limited. We hypothesized that CVD rsik factors might be different between lean CKD and obese CKD patients. 2,676 CKD patients recruited from 11 outpatients' hospitals. BMI and estimated glomerular filtration rate (eGFR) were calculated, and change of eGFR and CVD outcome during 2 years were collected. Patients were divided by BMI under cut off value of normal, thus 187 patients grouped in undernutrition (BMI <18.5 kg/m(2)). Systolic blood pressure (SBP), albumin, hemoglobin, age and prevalence of diabetes were lower in undernutrition group compared to non-undernutrition group. While smoking, urinary protein and baseline eGFR levels did not differ between the groups. The low BMI increased significantly the risk of CVD mortality, in spite of low prevalence of comorbidities and young age. This significance remained after adjusted for CVD risk factors, such as age, gender, smoking, diabetes, hemoglobin and positive for proteinuria (HR 3.15, 95% CI 1.73-5.52, p<0.01). On the other hand, BMI was not associated with the decline rate of eGFR. We concluded that BMI less than 18.5 kg/m(2) was an independent predictor of CVD, and that BMI did not effect on CKD progression in Japanese CKD. (C) 2012 by MEDIMOND s.r.l.