Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes

被引：13

作者：

Hung, Chi-Chih ^{[1
,2
]}

Yu, Pei-Hua ^{[1
,3
]}

Niu, Sheng-Wen ^{[4
]}

Kuo, I-Ching ^{[4
]}

Lee, Jia-Jung ^{[1
,2
]}

Shen, Feng-Ching ^{[1
]}

Chang, Jer-Ming ^{[1
,5
]}

Hwang, Shang-Jyh ^{[1
,5
]}

机构：

[1] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Nephrol, Kaohsiung 80708, Taiwan

[2] Kaohsiung Med Univ, Regenerat Med & Cell Therapy Res Ctr, Kaohsiung 80708, Taiwan

[3] Kaohsiung Med Univ, Coll Med, Grad Inst Clin Med, Kaohsiung 80708, Taiwan

[4] Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Internal Med, Kaohsiung 80145, Taiwan

[5] Kaohsiung Med Univ, Coll Med, Fac Renal Care, Kaohsiung 80708, Taiwan

来源：

JOURNAL OF CLINICAL MEDICINE | 2022年 / 11卷 / 10期

关键词：

obesity paradox; renal outcome; chronic kidney disease; body mass index; central obesity; waist-to-hip ratio; anemia; MALNUTRITION-INFLAMMATION COMPLEX; ABDOMINAL OBESITY; ALL-CAUSE; MORTALITY; RISK; CKD; PROGRESSION; OVERWEIGHT; SCORE;

D O I：

10.3390/jcm11102787

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Obesity-related nephropathy is associated with renal function progression. However, some studies have associated a high body mass index (BMI) with improved renal outcomes-this is referred to as the obesity paradox for renal outcomes, especially in relation to advanced chronic kidney disease (CKD). Central obesity can explain the obesity paradox in all-cause mortality. However, whether obesity or central obesity is associated with renal outcomes (renal replacement therapy or a 50% decline in the estimated glomerular filtration rate) in patients with advanced CKD remains unclear. Our study included 3605 Asian patients with CKD stages 1-5 divided into six groups according to their BMI (between 15 and 35 kg/m(2)). Through linear regression, BMI was positively associated with hemoglobin and albumin at CKD stages 4 and 5. In the competing risk Cox regression model, a high BMI (27.5-35 kg/m(2)) was associated with renal outcomes at CKD stages 1-3, but not stages 4 and 5. A high BMI was associated with renal outcomes in patients with hemoglobin >= 11 g/dL, but not <11 g/dL. A high waist-to-hip ratio was not associated with renal outcomes. We conclude that the CKD stage and anemia may explain the obesity paradox in renal outcomes in patients with CKD.

引用

页数：13

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