Association between kidney function, nutritional status and anthropometric measures in older people (original) (raw)
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Acta Medica Marisiensis, 2016
Obesity and chronic kidney disease are epidemic size. Chronic kidney disease (CKD) appears to be more common in obese, although interrelation is not supported by all authors.: The aim of the study was to investigate the effects of overweight and obesity on glomerular filtration rate (GFR) and the relationship between body mass index (BMI) and other risk factors for CKD.: This is a cross-sectional study on 627 patients admitted in a Nephrology Department between January 2007 - December 2011. Patients were divided according to eGFR in a CKD group and a non-CKD group. Patients were divided based on BMI in: normal (<25 kg/m: 43.70% patients were obese and 33.17% overweight. CKD prevalence was 58.69%. Logistic regression analysis showed that systolic blood pressure was the main determinant of CKD in our patients.: Lack of association between BMI and CKD was demonstrated in our study.
BMC Nephrology, 2013
Background: The number of individuals suffering from chronic kidney disease (CKD) is increasing. Therefore, early identification of modifiable predictors of CKD is highly desirable. Previous studies suggest an association between body mass index (BMI), metabolic factors and CKD. Methods: Data of 241 high risk patients with information on renal function and albuminuria from the Renal Disease in Vorarlberg (RENVOR) study (2010)(2011) were linked with long-term measurements of metabolic factors in the same patients from the population-based Vorarlberg Health Monitoring & Prevention Program (VHM&PP) cohort study (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005). Actual estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (ACR) were determined. BMI, blood pressure, fasting glucose, total cholesterol, triglycerides and Gammaglutamyltransferase (GGT) were available from previous health examinations performed up to 25 years ago. Linear regression models were applied to identify predictors of current renal function. Results: At all-time points BMI was significantly inversely associated with actual eGFR and positively with actual albuminuria in men, but not in women. Serum GGT and triglycerides were significantly positively associated with albuminuria in men at all-time points. Fasting glucose levels more than 20 years earlier were associated with increased albuminuria in women and reduced eGFR in men, whereas at later time points it was associated with albuminuria in men. Conclusions: BMI, serum GGT, and triglycerides are long-term predictors of renal function in men. In women however, anthropometric and metabolic parameters seem to be less predictive of eGFR and albuminuria.
Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study
High Blood Pressure & Cardiovascular Prevention
The present study was designed to provide information on the ability of several different anthropometric markers to reflect the renal impairment associated with body weight increase and to predict the development of renal alterations linked to overweight and obesity. In 574 subjects representative of the general population of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, with an age range between 57 and 73 years, we investigated the association between different anthropometric markers of body fat, as alternative to body mass index, and renal failure, to obtain information useful for determining their potential predictive value. Renal dysfunction was significantly associated with almost all anthropometric markers of adiposity related to body weight and body shape. After adjustment for confounders, such as age, sex, office blood pressure, serum glucose, antihypertensive drugs and smoking habit, association remained significant only for waist-to-hip ratio (WHR), lipid accumulation product (LAP) and visceral adiposity index (VAI). These 3 markers also displayed at the receiver operating curves (ROC) analysis the best ability to detect subjects with or without kidney dysfunction. The results of the present study provide evidence that WHR, LAP and VAI represent the best markers of renal dysfunction associated with visceral body fat accumulation.
Early chronic kidney disease in relation to body mass index in high risk outpatients
Folia Medica Facultatis Medicinae Universitatis Saraeviensis, 2017
The r enal damage is an emerging complication of excess weight. Aim of this study was to determine the occurrence of chronic kidney disease (CKD) in subjects depending on their weight and the influence of body mass index (BMI) on glomerular filtration (GF) rate decline in outpatients with hypertension and/or diabetes mellitus type 2. Methods: This observational, cross sectional, pilot study included 200 adult patients suffering from hypertension and/or diabetes mellitus type 2 from March 2012. to March 2013. in the Institute for Occupational Medicine of Canton Sarajevo. Renal function was evaluated by using MDRD equation and measurement of microalbuminuria and proteinuria in 24 - hour urine, using nefelometric method at the Institute of Clinical Biochemistry of the University Clinical Center in Sarajevo K/DOQI classification was used to define the stages of CKD. Results: Of the total 200 patients (62.5% male; mean age of 52.46 ± 8.2 years) most of them had a BMI of 25 - 30 (n=99; ...
Nutrition Journal, 2019
Background: Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods: A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m 2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m 2) and the association of dietary pattern with the outcomes aforementioned. Results: Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12-1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31-1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41-1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89-2.27, P < 0.01) weight status, increased cardiovascular risk by 10-31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02-1.29, P < 0.05).
Waist-to-height ratio is the best index of obesity in association with chronic kidney disease
Nutrition, 2007
Objective: Obesity is a risk factor for chronic kidney disease (CKD) and cardiovascular disease. The association between different indexes of obesity and CKD is unknown. This study evaluated the association between indexes of obesity and CKD. Methods: We reviewed 4611 participants including 2613 men and 1998 women in this communitybased cross-sectional study from 2003 to 2005. CKD was defined as a glomerular filtration rate slower than 60 mL/min per 1.73 m 2 by the Modification of Diet in Renal Disease formula. Indexes of obesity included body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio (WheiR). Traditional risk factors including diabetes, hypertension, smoking, and metabolic syndrome were also taken into consideration. Results: A total of 221 (4.8%) participants including 137 men and 84 women were found to have CKD. Participants with CKD were significantly older than those without (P Ͻ 0.001). In univariate logistic regression with adjustment for age, all indexes of obesity were associated with CKD (P Ͻ 0.001). In multivariate logistic regression with adjustment for age and gender, WheiR was significantly associated with CKD, independent of hypertension and diabetes (P ϭ 0.028). The adjusted odds ratios of WheiR (every 0.1 increment) was 2.74 (95% confidence interval 1.18 -6.72). Conclusion: Obesity, especially central obesity, is associated with CKD and the association is independent of hypertension, diabetes, and metabolic syndrome. In commonly used obesity indexes, WheiR is particularly associated with CKD.
Anthropometric measurements and markers of renal function in adults and older adults
Revista de Nutrição, 2016
Objective: To determine whether anthropometric indicators are associated with markers of renal function in adults and older adults. Methods: This cross-sectional study included 279 adults and older adults attending eight primary healthcare units in eastern Goiânia, Góias. Sociodemographic, lifestyle, and clinical data were collected using a standard questionnaire. Body mass index was categorized as overweight (≥25 kg/m²) or non-overweight. Waist circumference was classified as normal or high; chronic kidney disease was defined as a glomerular filtration rate below 60 mL/minutes/1.73 m²; micro/macroalbuminuria was defined as an albumin/creatinine ratio above 30 mg/g. The association between anthropometric indicators and renal function markers was assessed by multiple linear regression analysis. Results: Chronic kidney disease was present in 8.9% and micro/macroalbuminuria in 34.8% of the sample. The prevalence of overweight was 57.0%. Waist circumference and body mass index were posi...
Nutrients
Nutritional status is a predictor of adverse outcomes and mortality in patients with advanced chronic kidney disease (ACKD). This study aimed to explore and evaluate risk factors related to nutritional status, body composition, and inflammatory profile in patients with ACKD compared with age- and sex-matched controls in a Mediterranean cohort of the Spanish population. Out of 200 volunteers recruited, 150 participants (64%) were included, and a case-control study was conducted on 75 ACKD patients (stages 4–5), matched individually with controls at a ratio of 1:1 for both age and sex. At enrolment, demographic, clinical, anthropometric, and laboratory parameters were measured. Bioimpedance analysis (BIA) was used to assess both body composition and hydration status. ACKD patients had lower body cell mass (BCM%), muscle mass (MM%) phase angle (PA), s-albumin, and higher C-reactive protein (s-CRP) than controls (at least, p < 0.05). PA correlated positively with BCM% (cases: r = 0.8...
Nutrition, 2014
Objective: Chronic kidney disease (CKD) is associated with metabolic disorders, including insulin resistance (IR), mainly when associated with obesity and characterized by high abdominal adiposity (AbAd). Anthropometric measures are recommended for assessing AbAd in clinical settings, but their accuracies need to be evaluated. The aim of this study was to evaluate the precision of different anthropometric measures of AbAd in patients with CKD. We also sought to determine the AbAd association with high homeostasis model assessment index of insulin resistance (HOMA-IR) values and the cutoff point for AbAd index to predict high HOMA-IR values. Methods: A subset of clinically stable nondialyzed patients with CKD followed at a multidisciplinary outpatient clinic was enrolled in this cross-sectional study. The accuracy of the following anthropometric indices: waist circumference, waist-to-hip ratio, conicity index and waist-to-height ratio (WheiR) to assess AbAd, was evaluated using trunk fat, by dual x-ray absorptiometry (DXA), as a reference method. HOMA-IR was estimated to stratify patients in high and low HOMA-IR groups. The total area under the receiver-operating characteristic curves (AUC-ROC; sensitivity/specificity) was calculated: AbAd with high HOMA-IR values (95% confidence interval [CI]). Results: We studied 134 patients (55% males; 54% overweight/obese, body mass index ! 25 kg/m 2 , age 64.9 AE 12.5 y, estimated glomerular filtration rate 29.0 AE 12.7 mL/min). Among studied AbAd indices, WheiR was the only one to show correlation with DXA trunk fat after adjusting for confounders (P < 0.0001). Thus, WheiR was used to evaluate the association between AbAd with HOMA-IR values (r ¼ 0.47; P < 0.0001). The cutoff point for WheiR as a predictor for high HOMA-IR values was 0.55 (AUC-ROC ¼ 0.69 AE 0.05; 95% CI, 0.60-0.77; sensitivity/specificity, 68.9/61.9). Conclusions: WheiR is recommended as an effective and precise anthropometric index to assess AbAd and to predict high HOMA-IR values in nondialyzed patients with CKD.