Obesity, Metabolic Abnormality, and Progression of CKD

Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Rationale & Objective: Recent studies have yielded conflicting findings on the association between obesity and progression of chronic kidney disease (CKD). Few studies have evaluated whether metabolic abnormalities may accelerate the rate of progression of CKD. Study Design: Prospective observational cohort study. Setting & Participants: 1,940 participants from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) Predictors: Obesity and metabolic abnormality. Obesity was defined as body mass index ≥ 25 kg/m2. Metabolic abnormality was defined as the presence of 3 or more of the following 5 components: hypertension, fasting glucose level > 125 mg/dL or the presence of type 2 diabetes, triglyceride level > 150 mg/dL or use of lipid-lowering drugs, high-density lipoprotein cholesterol level ≤ 40 mg/dL in men and ≤ 50 mg/dL in women, and high-sensitivity C-reactive protein level > 1 mg/L. Outcome: A composite of a 50% decline in estimated glomerular filtration rate from the baseline value or end-stage kidney disease. Analytic Approach: Multivariable cause-specific hazards models implemented to assess the association between obesity, metabolic abnormality, and CKD progression. Results: During a mean follow-up of 3.1 years, the primary outcome occurred in 395 (20.4%) patients. In multivariable analyses, after adjustment for confounding factors, obesity and metabolic abnormality were significantly associated with 1.41-fold (95% CI, 1.08-1.83; P = 0.01) and 1.38-fold (95% CI, 1.03-1.85; P = 0.03) increased risk for adverse renal outcomes, respectively. Patients were categorized into 4 groups depending on the presence of obesity and metabolic abnormality. Compared with those with neither obesity nor metabolic abnormality, those with obesity and metabolic abnormality had a greater risk for CKD progression (HR, 1.53; P = 0.03). Those with obesity without metabolic abnormality also had a higher rate of CKD progression (HR, 1.97; P = 0.01). Limitations: Observational study, limited power to detect cardiovascular disease outcomes, unmeasured confounders. Conclusions: Both metabolic abnormality and obesity are associated with a significantly increased risk for CKD progression. Notably, obese patients without metabolic abnormality also have an elevated risk for CKD progression.

Original languageEnglish
Pages (from-to)400-410
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume72
Issue number3
DOIs
Publication statusPublished - 2018 Sep

Fingerprint

Chronic Renal Insufficiency
Obesity
Disease Progression
Observational Studies
Cohort Studies
Glomerular Filtration Rate
Proportional Hazards Models
C-Reactive Protein
Type 2 Diabetes Mellitus
HDL Cholesterol
Chronic Kidney Failure
Fasting
Triglycerides
Body Mass Index
Cardiovascular Diseases
Prospective Studies
Hypertension
Kidney
Lipids
Glucose

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators (2018). Obesity, Metabolic Abnormality, and Progression of CKD. American Journal of Kidney Diseases, 72(3), 400-410. https://doi.org/10.1053/j.ajkd.2018.02.362
Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators. / Obesity, Metabolic Abnormality, and Progression of CKD. In: American Journal of Kidney Diseases. 2018 ; Vol. 72, No. 3. pp. 400-410.
@article{095d39768ad04d6da93b111a6bdde04c,
title = "Obesity, Metabolic Abnormality, and Progression of CKD",
abstract = "Rationale & Objective: Recent studies have yielded conflicting findings on the association between obesity and progression of chronic kidney disease (CKD). Few studies have evaluated whether metabolic abnormalities may accelerate the rate of progression of CKD. Study Design: Prospective observational cohort study. Setting & Participants: 1,940 participants from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) Predictors: Obesity and metabolic abnormality. Obesity was defined as body mass index ≥ 25 kg/m2. Metabolic abnormality was defined as the presence of 3 or more of the following 5 components: hypertension, fasting glucose level > 125 mg/dL or the presence of type 2 diabetes, triglyceride level > 150 mg/dL or use of lipid-lowering drugs, high-density lipoprotein cholesterol level ≤ 40 mg/dL in men and ≤ 50 mg/dL in women, and high-sensitivity C-reactive protein level > 1 mg/L. Outcome: A composite of a 50{\%} decline in estimated glomerular filtration rate from the baseline value or end-stage kidney disease. Analytic Approach: Multivariable cause-specific hazards models implemented to assess the association between obesity, metabolic abnormality, and CKD progression. Results: During a mean follow-up of 3.1 years, the primary outcome occurred in 395 (20.4{\%}) patients. In multivariable analyses, after adjustment for confounding factors, obesity and metabolic abnormality were significantly associated with 1.41-fold (95{\%} CI, 1.08-1.83; P = 0.01) and 1.38-fold (95{\%} CI, 1.03-1.85; P = 0.03) increased risk for adverse renal outcomes, respectively. Patients were categorized into 4 groups depending on the presence of obesity and metabolic abnormality. Compared with those with neither obesity nor metabolic abnormality, those with obesity and metabolic abnormality had a greater risk for CKD progression (HR, 1.53; P = 0.03). Those with obesity without metabolic abnormality also had a higher rate of CKD progression (HR, 1.97; P = 0.01). Limitations: Observational study, limited power to detect cardiovascular disease outcomes, unmeasured confounders. Conclusions: Both metabolic abnormality and obesity are associated with a significantly increased risk for CKD progression. Notably, obese patients without metabolic abnormality also have an elevated risk for CKD progression.",
author = "{Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators} and Yun, {Hae Ryong} and Hyoungnae Kim and Park, {Jung Tak} and Chang, {Tae Ik} and Yoo, {Tae Hyun} and Kang, {Shin Wook} and Choi, {Kyu Hun} and Suah Sung and Kim, {Soo Wan} and Joongyub Lee and Oh, {Kook Hwan} and Curie Ahn and Han, {Seung Hyeok} and Seohyun Park and Jhee, {Jong Hyun} and Kee, {Youn Kyung} and Chae, {Dong Wan} and Chin, {Ho Jun} and Park, {Hayne Cho} and Kyubeck Lee and Kim, {Yong Soo} and Wookyung Chung and Hwang, {Young Hwan} and Kim, {Yeong Hoon} and Kang, {Sun Woo}",
year = "2018",
month = "9",
doi = "10.1053/j.ajkd.2018.02.362",
language = "English",
volume = "72",
pages = "400--410",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "W.B. Saunders Ltd",
number = "3",

}

Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators 2018, 'Obesity, Metabolic Abnormality, and Progression of CKD', American Journal of Kidney Diseases, vol. 72, no. 3, pp. 400-410. https://doi.org/10.1053/j.ajkd.2018.02.362

Obesity, Metabolic Abnormality, and Progression of CKD. / Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators.

In: American Journal of Kidney Diseases, Vol. 72, No. 3, 09.2018, p. 400-410.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Obesity, Metabolic Abnormality, and Progression of CKD

AU - Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators

AU - Yun, Hae Ryong

AU - Kim, Hyoungnae

AU - Park, Jung Tak

AU - Chang, Tae Ik

AU - Yoo, Tae Hyun

AU - Kang, Shin Wook

AU - Choi, Kyu Hun

AU - Sung, Suah

AU - Kim, Soo Wan

AU - Lee, Joongyub

AU - Oh, Kook Hwan

AU - Ahn, Curie

AU - Han, Seung Hyeok

AU - Park, Seohyun

AU - Jhee, Jong Hyun

AU - Kee, Youn Kyung

AU - Chae, Dong Wan

AU - Chin, Ho Jun

AU - Park, Hayne Cho

AU - Lee, Kyubeck

AU - Kim, Yong Soo

AU - Chung, Wookyung

AU - Hwang, Young Hwan

AU - Kim, Yeong Hoon

AU - Kang, Sun Woo

PY - 2018/9

Y1 - 2018/9

N2 - Rationale & Objective: Recent studies have yielded conflicting findings on the association between obesity and progression of chronic kidney disease (CKD). Few studies have evaluated whether metabolic abnormalities may accelerate the rate of progression of CKD. Study Design: Prospective observational cohort study. Setting & Participants: 1,940 participants from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) Predictors: Obesity and metabolic abnormality. Obesity was defined as body mass index ≥ 25 kg/m2. Metabolic abnormality was defined as the presence of 3 or more of the following 5 components: hypertension, fasting glucose level > 125 mg/dL or the presence of type 2 diabetes, triglyceride level > 150 mg/dL or use of lipid-lowering drugs, high-density lipoprotein cholesterol level ≤ 40 mg/dL in men and ≤ 50 mg/dL in women, and high-sensitivity C-reactive protein level > 1 mg/L. Outcome: A composite of a 50% decline in estimated glomerular filtration rate from the baseline value or end-stage kidney disease. Analytic Approach: Multivariable cause-specific hazards models implemented to assess the association between obesity, metabolic abnormality, and CKD progression. Results: During a mean follow-up of 3.1 years, the primary outcome occurred in 395 (20.4%) patients. In multivariable analyses, after adjustment for confounding factors, obesity and metabolic abnormality were significantly associated with 1.41-fold (95% CI, 1.08-1.83; P = 0.01) and 1.38-fold (95% CI, 1.03-1.85; P = 0.03) increased risk for adverse renal outcomes, respectively. Patients were categorized into 4 groups depending on the presence of obesity and metabolic abnormality. Compared with those with neither obesity nor metabolic abnormality, those with obesity and metabolic abnormality had a greater risk for CKD progression (HR, 1.53; P = 0.03). Those with obesity without metabolic abnormality also had a higher rate of CKD progression (HR, 1.97; P = 0.01). Limitations: Observational study, limited power to detect cardiovascular disease outcomes, unmeasured confounders. Conclusions: Both metabolic abnormality and obesity are associated with a significantly increased risk for CKD progression. Notably, obese patients without metabolic abnormality also have an elevated risk for CKD progression.

AB - Rationale & Objective: Recent studies have yielded conflicting findings on the association between obesity and progression of chronic kidney disease (CKD). Few studies have evaluated whether metabolic abnormalities may accelerate the rate of progression of CKD. Study Design: Prospective observational cohort study. Setting & Participants: 1,940 participants from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) Predictors: Obesity and metabolic abnormality. Obesity was defined as body mass index ≥ 25 kg/m2. Metabolic abnormality was defined as the presence of 3 or more of the following 5 components: hypertension, fasting glucose level > 125 mg/dL or the presence of type 2 diabetes, triglyceride level > 150 mg/dL or use of lipid-lowering drugs, high-density lipoprotein cholesterol level ≤ 40 mg/dL in men and ≤ 50 mg/dL in women, and high-sensitivity C-reactive protein level > 1 mg/L. Outcome: A composite of a 50% decline in estimated glomerular filtration rate from the baseline value or end-stage kidney disease. Analytic Approach: Multivariable cause-specific hazards models implemented to assess the association between obesity, metabolic abnormality, and CKD progression. Results: During a mean follow-up of 3.1 years, the primary outcome occurred in 395 (20.4%) patients. In multivariable analyses, after adjustment for confounding factors, obesity and metabolic abnormality were significantly associated with 1.41-fold (95% CI, 1.08-1.83; P = 0.01) and 1.38-fold (95% CI, 1.03-1.85; P = 0.03) increased risk for adverse renal outcomes, respectively. Patients were categorized into 4 groups depending on the presence of obesity and metabolic abnormality. Compared with those with neither obesity nor metabolic abnormality, those with obesity and metabolic abnormality had a greater risk for CKD progression (HR, 1.53; P = 0.03). Those with obesity without metabolic abnormality also had a higher rate of CKD progression (HR, 1.97; P = 0.01). Limitations: Observational study, limited power to detect cardiovascular disease outcomes, unmeasured confounders. Conclusions: Both metabolic abnormality and obesity are associated with a significantly increased risk for CKD progression. Notably, obese patients without metabolic abnormality also have an elevated risk for CKD progression.

UR - http://www.scopus.com/inward/record.url?scp=85046799429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046799429&partnerID=8YFLogxK

U2 - 10.1053/j.ajkd.2018.02.362

DO - 10.1053/j.ajkd.2018.02.362

M3 - Article

C2 - 29728317

AN - SCOPUS:85046799429

VL - 72

SP - 400

EP - 410

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 3

ER -

Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators. Obesity, Metabolic Abnormality, and Progression of CKD. American Journal of Kidney Diseases. 2018 Sep;72(3):400-410. https://doi.org/10.1053/j.ajkd.2018.02.362