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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)
  • Emma Davis, Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute
  • Katrina Campbell, Department of Nephrology, Princess Alexandra Hospital
  • Glenda Gobe, University of Queensland
  • Carmel Hawley, University of Queensland
  • Nicole Isbel, University of Queensland
  • David W Johnson, University of Queensland
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/m2n = 174), the risk of the composite primary outcome was significantly lower in both the overweight (BMI 25–29.9 kg/m2n = 293; adjusted hazard ratio [HR] 0.50, 95 % CI 0.33-0.75) and obese class I/II groups (BMI 30–39.9 kg/m2n = 288; HR 0.62, 95 % CI 0.41-0.93), but not in the obese class III group (BMI ≥40 kg/m2n = 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.
Keywords
  • Anthropometry,
  • Body mass index,
  • Chronic kidney disease,
  • Conicity index,
  • Mortality,
  • Waist circumference
Publication Date
December, 2016
DOI
http://dx.doi.org/10.1186/s12882-016-0290-y
Publisher Statement
Published version

Davis, E., Campbell, K., Gobe, G., Hawley, C., Isbel, N., & Johnson, D. W. (2016). 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, 17(1).

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Copyright © 2016 The Author(s).


Citation Information
Emma Davis, Katrina Campbell, Glenda Gobe, Carmel Hawley, et al.. "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 Vol. 17 Iss. 1 (2016) p. 1 - 10 ISSN: 1471-2369
Available at: http://works.bepress.com/katrina-campbell/16/
Creative Commons license
Creative Commons License
This work is licensed under a Creative Commons CC_BY International License.