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Obesity and change in estimated GFR among older adults.
Tuesday,2012-11-06 12:18 America/Los_Angeles — eenright
| Title | Obesity and change in estimated GFR among older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | de Boer, IH, Katz, R, Fried, LF, Ix, JH, Luchsinger, J, Sarnak, MJ, Shlipak, MG, Siscovick, DS, Kestenbaum, B |
| Journal | Am J Kidney Dis |
| Volume | 54 |
| Issue | 6 |
| Pagination | 1043-51 |
| Date Published | 2009 Dec |
| ISSN | 1523-6838 |
| Keywords | Aged, Aging, Body Composition, Body Mass Index, Chronic Disease, Cohort Studies, Creatinine, Cystatin C, Female, Glomerular Filtration Rate, Humans, Kidney, Kidney Diseases, Longitudinal Studies, Male, Obesity, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>The prevalence of chronic kidney disease is growing most rapidly among older adults; however, determinants of impaired kidney function in this population are not well understood. Obesity assessed in midlife has been associated with chronic kidney disease.</p><p><b>STUDY DESIGN: </b>Cohort study.</p><p><b>SETTING & PARTICIPANTS: </b>4,295 participants in the community-based Cardiovascular Health Study, aged >or= 65 years.</p><p><b>PREDICTORS: </b>Body mass index, waist circumference, and fat mass measured using bioelectrical impedance.</p><p><b>OUTCOME: </b>Change in glomerular filtration rate (GFR) during 7 years of follow-up.</p><p><b>MEASUREMENTS: </b>Longitudinal estimates of GFR calculated using the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation.</p><p><b>RESULTS: </b>Estimated GFR decreased by an average of 0.4 +/- 3.6 mL/min/1.73 m(2)/y, and rapid GFR loss (>3 mL/min/1.73 m(2)/y) occurred in 693 participants (16%). Baseline body mass index, waist circumference, and fat mass were each associated with increased risk of rapid GFR loss: ORs, 1.19 (95% CI, 1.09-1.30) per 5 kg/m(2), 1.25 (95% CI, 1.16-1.36) per 12 cm, and 1.14 (95% CI, 1.05-1.24) per 10 kg after adjustment for age, sex, race, and smoking. The magnitude of increased risk was larger for participants with estimated GFR < 60 mL/min/1.73 m(2) at baseline (P for interaction < 0.05). Associations were substantially attenuated by further adjustment for diabetes, hypertension, and C-reactive protein level. Obesity measurements were not associated with change in GFR estimated using serum cystatin C level.</p><p><b>LIMITATIONS: </b>Few participants with advanced chronic kidney disease at baseline, no direct GFR measurements.</p><p><b>CONCLUSION: </b>Obesity may be a modifiable risk factor for the development and progression of kidney disease in older adults.</p> |
| DOI | 10.1053/j.ajkd.2009.07.018 |
| Alternate Journal | Am. J. Kidney Dis. |
| PubMed ID | 19782454 |
| PubMed Central ID | PMC2787647 |
| Grant List | N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-8507983 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States KL2 RR025015-01 / RR / NCRR NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-8507982 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States KL2 RR025015 / RR / NCRR NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85079-84 / HC / NHLBI NIH HHS / United States UL1 TR000423 / TR / NCATS NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States 1KL2RR025015-01 / RR / NCRR NIH HHS / United States |