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Obesity is not associated with progression to end stage renal disease in patients with biopsy-proven glomerular diseases
- Source :
- BMC Nephrology, Vol 20, Iss 1, Pp 1-7 (2019), BMC Nephrology
- Publication Year :
- 2019
- Publisher :
- BMC, 2019.
-
Abstract
- Background:\ud \ud Body mass index (BMI) is associated with renal disease progression in unspecified CKD. The relationship between BMI and primary glomerular disease (GN) may be more complex. We aimed to evaluate the association between BMI and renal disease progression in patients with primary glomerular disease (GN).\ud Methods:\ud \ud This was a single-centre retrospective cohort study performed in adult patients with biopsy-proven primary GN (excluding minimal change disease) from January 2000 to December 2015, with follow-up data until June 2017. BMI at time of biopsy was categorised as ≤25 kg/m2, > 25 to ≤30 kg/m2 and > 30 kg/m2. We used univariate and multivariate survival analyses to evaluate factors associated with progression to a composite endpoint of stage 5 CKD or renal replacement therapy (Major Adverse Renal Event - MARE) censoring for competing risk of death using Fine and Gray subdistribution hazards model.\ud Results:\ud \ud We included 560 patients with biopsy-proven primary GN and available BMI data: 66.1% were male with median age 54.8 (IQR 41.1–66.2) years and BMI 28.2 (IQR 24.9–32.1) kg/m2. Those with BMI 25-30 kg/m2 (n = 210) and with BMI > 30 kg/m2 (n = 207) were older (p = 0.007) with higher systolic and diastolic blood pressures (p = 0.02 and 0.004 respectively) than those with BMI 30 kg/m2 of biopsies (p = 0.01)), but similar proportions of other GN diagnoses across BMI groups. Baseline eGFR (p = 0.40) and uPCR (p = 0.17) were similar across BMI groups. There was no interaction between BMI and time to MARE (log-rank p = 0.98) or death (log-rank p = 0.42). Censoring for competing risk of death, factors associated with progression to MARE were: younger age, lower baseline eGFR and higher uPCR, but not BMI (SHR 0.99, 95%CI 0.97–1.01, p = 0.31) nor blood pressure or GN diagnosis.\ud Conclusion:\ud \ud BMI was not associated with progression to MARE in this patient cohort with primary GN. Efforts should be directed to managing other known risk factors for CKD progression.
- Subjects :
- Nephrology
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Kidney Glomerulus
030232 urology & nephrology
030204 cardiovascular system & hematology
lcsh:RC870-923
End stage renal disease
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
CKD
Humans
Minimal change disease
Renal replacement therapy
Obesity
Body mass index
Aged
Retrospective Studies
Glomerular disease
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
Blood pressure
Cohort
Disease Progression
Kidney Failure, Chronic
Female
Risk factor
business
Research Article
Glomerular Filtration Rate
Subjects
Details
- Language :
- English
- ISSN :
- 14712369
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Nephrology
- Accession number :
- edsair.doi.dedup.....5a52652ee038e52b19cd50c31e2ce25d