Increased Risk of Chronic Kidney Disease Associated With Weight Gain in Healthy Adults: Insight From Metabolic Profiles and Body Composition

Hae Ryong Yun, Hyung Woo Kim, Tae Ik Chang, Ea Wha Kang, Young Su Joo, Ki Heon Nam, Hyoungnae Kim, Jung Tak Park, Tae Hyun Yoo, Shin Wook Kang, Seung Hyeok Han

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4 Citations (Scopus)


Objective: Obesity is an established risk factor for kidney damage. In this study, we explored the long-term association of changes in body mass index (BMI) over time with incident chronic kidney disease (CKD). Methods: For this analysis, 5,393 middle-aged adults without comorbidities in the Korean Genome and Epidemiology Study (KoGES) were included. Group-based trajectory modeling was used to determine the patterns of BMI change (decreasing, stable, and increasing BMI) between baseline and year 4. The primary outcome was the subsequent development of CKD from year 4. A multivariable Cox proportional hazards model was constructed to determine the risk of incident CKD according to BMI trajectories. Results: During 55,327 person-years, incident CKD occurred in 354 (6.5%) participants; 6.0, 6.1, and 7.8 per 1,000 person-years across the trajectories, respectively (P = 0.005). In the multivariable-adjusted Cox proportional hazards model, the increasing BMI trajectory was associated with a 1.4-fold [hazard ratio (HR), 1.41; 95% CI, 1.06–1.87] a higher risk of incident CKD compared with stable BMI trajectory. This association was stronger for overweight and obese individuals. The HRs for CKD development in these two groups were 1.6 (95% CI, 1.06–1.87) and 2.2 (95% CI, 1.40–3.48), respectively. While the increasing BMI group was gaining weight, there were concomitant increases in blood pressure, insulin resistance, serum concentrations of total cholesterol, triglyceride, and high-sensitivity C-reactive protein (hs-CRP), and fat mass, but high-density lipoprotein (HDL)-cholesterol level and muscle-to-fat (MF) ratio decreased. Conclusion: Weight gain is associated with an increased risk of incident CKD in healthy adults. This association is attributed to worsening metabolic profiles and increasing fat mass.

Original languageEnglish
Article number705881
JournalFrontiers in Medicine
Publication statusPublished - 2021 Sept 28

Bibliographical note

Funding Information:
This study was supported by the Ministry for Health and Welfare, Republic of Korea [4845-301 and 4851-302], and also supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (Grant Number: HC15C1129). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© Copyright © 2021 Yun, Kim, Chang, Kang, Joo, Nam, Kim, Park, Yoo, Kang and Han.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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