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

Research Article

Emma Davis¹  Glenda Gobe¹  Nicole Isbel²  Katrina Campbell²  Carmel Hawley³  David W. Johnson³ 

[1] Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, QLD, Australia;Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, QLD, Australia;Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia;Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, QLD, Australia;Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia;Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia;

关键词: Anthropometry;    Body mass index;    Chronic kidney disease;    Conicity index;    Mortality;    Waist circumference;   

DOI  :  10.1186/s12882-016-0290-y

 received in 2015-08-04, accepted in 2016-06-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAlthough 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.MethodsThe 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.ResultsOver 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/m2, n = 174), the risk of the composite primary outcome was significantly lower in both the overweight (BMI 25–29.9 kg/m2, n = 293; adjusted hazard ratio [HR] 0.50, 95 % CI 0.33-0.75) and obese class I/II groups (BMI 30–39.9 kg/m2, n = 288; HR 0.62, 95 % CI 0.41-0.93), but not in the obese class III group (BMI ≥40 kg/m2, n = 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.ConclusionBMI 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.

【 授权许可】

CC BY   
© The Author(s). 2016

【 图 表 】

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