Association of anthropometric measures with kidney disease progression and mortality: A retrospective cohort study of pre-dialysis chronic kidney disease patients referred to a specialist renal service

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Davis, Emma
Campbell, Katrina
Gobe, Glenda
Hawley, Carmel
Isbel, Nicole
Johnson, David W
Griffith University Author(s)
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2016
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https://creativecommons.org/licenses/by/4.0/
Abstract

Background: Although elevated body mass index (BMI) is a predictor of better clinical outcomes in dialysis patients, the evidence in pre-dialysis chronic kidney disease (CKD) is conflicting. Clinical measures of central obesity may be better prognostic indicators, although investigation has been limited. The aim of this study was to assess the predictive value of anthropometric measures for kidney failure progression and mortality in stage 3-4 CKD. Methods: The study included newly referred stage 3-4 CKD patients at a single centre between 1/1/2008 and 31/12/2010. The associations between clinical measures of obesity (BMI, waist circumference [WC] and conicity index [ConI]) and time to a composite primary outcome of doubling of serum creatinine, commencement of renal replacement therapy or mortality were evaluated using the Kaplan-Meier method and multivariable Cox regression models. Results: Over a median follow-up period of 3.3 years, 229 (25.4 %) patients of a total population of 903 experienced the composite primary renal outcome. When compared to normal BMI (18.5-24.9 kg/m2, n = 174), the risk of the composite primary outcome was significantly lower in both the overweight (BMI 25-29.9 kg/m2, n = 293; adjusted hazard ratio [HR] 0.50, 95 % CI 0.33-0.75) and obese class I/II groups (BMI 30-39.9 kg/m2, n = 288; HR 0.62, 95 % CI 0.41-0.93), but not in the obese class III group (BMI ≥40 kg/m2, n = 72; HR 0.94, 95 % CI 0.52-1.69). All-cause mortality was also lower in the overweight group (HR 0.50, 95 % CI 0.30-0.83). WC and ConI were not associated with either the composite primary outcome or mortality. Conclusion: BMI in the overweight range is associated with reduced risks of kidney disease progression and all-cause mortality in stage 3-4 CKD. WC and ConI were not independent predictors of these outcomes in this population.

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BMC Nephrology
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© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Clinical sciences
Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Anthropometry
Body mass index
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Davis, E; Campbell, K; Gobe, G; Hawley, C; Isbel, N; Johnson, DW, Association of anthropometric measures with kidney disease progression and mortality: A retrospective cohort study of pre-dialysis chronic kidney disease patients referred to a specialist renal service, BMC Nephrology, 2016, 17
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