7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Relationship between body mass index and renal function deterioration among the Taiwanese chronic kidney disease population

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          This study investigated the characteristics of patients with different chronic kidney disease (CKD) stages according to various body mass index (BMI) categories and determined the influence of BMI in renal function deterioration. We conducted a multicenter, longitudinal cohort study based on the Epidemiology and Risk Factors Surveillance of CKD project (2008–2013) and National Health Insurance Research Database (2001–2013). A total of 7357 patients with CKD aged 20–85 years from 14 hospitals were included in the study. A higher male sex, diabetes mellitus (DM) and hypertension were noted among overweight and obese CKD patients, while more cancer prevalence was noted among underweight CKD patients. Charlson comorbidity index was significantly higher and correlated with BMI among late CKD patients. Patients with BMI < 18.5 kg/m 2 exhibited non-significantly higher events of eGFR decline events in both early and late CKD stages than other BMI groups. BMI alone is not a determinant of CKD progression among our Taiwanese CKD patients. Obesity should be re-defined and body weight manipulation should be individualized in CKD patients.

          Related collections

          Most cited references42

          • Record: found
          • Abstract: found
          • Article: not found

          Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.

          The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines in 2012 to provide guidance on the evaluation, management, and treatment of chronic kidney disease (CKD) in adults and children who are not receiving renal replacement therapy. The KDIGO CKD Guideline Development Work Group defined the scope of the guideline, gathered evidence, determined topics for systematic review, and graded the quality of evidence that had been summarized by an evidence review team. Searches of the English-language literature were conducted through November 2012. Final modification of the guidelines was informed by the KDIGO Board of Directors and a public review process involving registered stakeholders. The full guideline included 110 recommendations. This synopsis focuses on 10 key recommendations pertinent to definition, classification, monitoring, and management of CKD in adults.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Body mass index and the risk of development of end-stage renal disease in a screened cohort.

            Obesity is associated with proteinuria and could be a risk factor for end-stage renal disease (ESRD). However, few studies have examined the significance of body mass index (BMI) as a risk factor for the development of ESRD in the general population. We examined the relationship between BMI and the development of ESRD using data from a 1983 community-based screening in Okinawa, Japan. Screenees who developed ESRD by the end of 2000 were identified through the Okinawa Dialysis Study registry. BMI data were available for 100,753 screenees (47,504 men and 53,249 women) aged >/=20 years. The cumulative incidence of ESRD was analyzed according to the quartile of BMI: /=25.5 kg/m(2). The mean (SD) BMI of the screenees was 23.4 (3.3) kg/m(2) (range 7.9 to 59.1 kg/m(2)); the mean was 23.4 kg/m(2) for both men and women. During the follow-up period, 404 screenees (232 men and 172 women) developed ESRD. The cumulative incidences of ESRD per 1000 screenees were, from the lowest to highest BMI quartile, 2.48, 3.79, 3.86, and 5.81. The odds ratio (95% CI) of BMI for developing ESRD, after adjustment for age, sex, systolic blood pressure, and proteinuria, was 1.273 (1.121-1.446, P= 0.0002) for men and 0.950 (0.825-1.094, not significant) for women. We found that BMI was associated with an increased risk of the development of ESRD in men in the general population in Okinawa. The maintenance of optimal body weight may reduce the risk of ESRD.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Survival advantages of obesity in dialysis patients.

              In the general population, a high body mass index (BMI; in kg/m(2)) is associated with increased cardiovascular disease and all-cause mortality. However, the effect of overweight (BMI: 25-30) or obesity (BMI: >30) in patients with chronic kidney disease (CKD) undergoing maintenance hemodialysis (MHD) is paradoxically in the opposite direction; ie, a high BMI is associated with improved survival. Although this "reverse epidemiology" of obesity or dialysis-risk-paradox is relatively consistent in MHD patients, studies in CKD patients undergoing peritoneal dialysis have yielded mixed results. Growing confusion has developed among physicians, some of whom are no longer confident about whether to treat obesity in CKD patients. A similar reverse epidemiology of obesity has been described in geriatric populations and in patients with chronic heart failure (CHF). Possible causes of the reverse epidemiology of obesity include a more stable hemodynamic status, alterations in circulating cytokines, unique neurohormonal constellations, endotoxin-lipoprotein interaction, reverse causation, survival bias, time discrepancies among competitive risk factors, and malnutrition-inflammation complex syndrome. Reverse epidemiology may have significant clinical implications in the management of dialysis, CHF, and geriatric patients, ie, populations with extraordinarily high mortality. Exploring the causes and consequences of the reverse epidemiology of obesity in dialysis patients can enhance our insights into similar paradoxes observed for other conventional risk factors, such as blood pressure and serum cholesterol and homocysteine concentrations, and in other populations such as those with CHF, advanced age, cancer, or AIDS. Weight-gaining interventional studies in dialysis patients are urgently needed to ascertain whether they can improve survival and quality of life.
                Bookmark

                Author and article information

                Contributors
                kao@ndmctsgh.edu.tw
                linyf@s.tmu.edu.tw
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                2 May 2018
                2 May 2018
                2018
                : 8
                : 6908
                Affiliations
                [1 ]ISNI 0000 0004 0634 0356, GRID grid.260565.2, Graduate Institute of Life Sciences, , National Defense Medical Center, ; Taipei, Taiwan
                [2 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Performance Appraisal Section, Secretary Office, Shuang Ho Hospital, , Taipei Medical University, ; Taipei, Taiwan
                [3 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Department of Internal Medicine, , School of Medicine, College of Medicine, Taipei Medical University, ; Taipei, Taiwan
                [4 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Division of Nephrology, Department of Internal Medicine, , Shuang Ho Hospital, Taipei Medical University, ; Taipei, Taiwan
                [5 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Graduate Institute of Clinical Medicine, , College of Medicine, Taipei Medical University, ; Taipei, Taiwan
                [6 ]ISNI 0000 0004 0546 0241, GRID grid.19188.39, Institute of Epidemiology and Preventive Medicine, , College of Public Health, National Taiwan University, ; Taipei, Taiwan
                [7 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, School of Nursing, College of Nursing, , Taipei Medical University, ; Taipei, Taiwan
                [8 ]Kidney Disease Prevention Foundation, Taipei, Taiwan
                [9 ]Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
                [10 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Department of Critical Care Medicine, , Shuang Ho Hospital, Taipei Medical University, ; Taipei, Taiwan
                [11 ]ISNI 0000 0004 0634 0356, GRID grid.260565.2, School of Public Health, , National Defense Medical Center, ; Taipei, Taiwan
                [12 ]ISNI 0000 0004 0572 9992, GRID grid.415011.0, Department of Medical Education and Research, , Kaohsiung Veterans General Hospital, ; Kaohsiung, Taiwan
                [13 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, School of Public Health, , College of Public Health and Nutrition, Taipei Medical University, ; Taipei, Taiwan
                [14 ]ISNI 0000 0004 1937 1063, GRID grid.256105.5, Division of Nephrology, Department of Medicine, , Fu-Jen Catholic University Hospital, School of Medicine, Fu-Jen Catholic University, ; Taipei, Taiwan
                [15 ]Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
                [16 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, School of Public Health, Graduate Institute of Clinical Medical Science, , China Medical University, ; Taichung, Taiwan
                [17 ]GRID grid.413804.a, Division of Nephrology, , Kaohsiung Chang Gung Memorial Hospital, Chang Gung Medical University, ; Kaohsiung, Taiwan
                [18 ]ISNI 0000 0004 0572 7372, GRID grid.413814.b, The Division of Nephrology, , Changhua Christian Hospital, ; Changhua, Taiwan
                [19 ]ISNI 0000 0004 0620 9374, GRID grid.412027.2, Division of Nephrology, Department of Medicine, , Kaohsiung Medical University Hospital, ; Kaohsiung, Taiwan
                [20 ]ISNI 0000 0004 0532 3255, GRID grid.64523.36, Division of Nephrology, Department of Internal Medicine, , Cheng Kung University Medical Center, ; Tainan, Taiwan
                Author information
                http://orcid.org/0000-0002-8038-0925
                Article
                24757
                10.1038/s41598-018-24757-6
                5932053
                29720598
                b491d97f-911c-4110-a3e9-facc2abfb885
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 12 October 2017
                : 22 March 2018
                Categories
                Article
                Custom metadata
                © The Author(s) 2018

                Uncategorized
                Uncategorized

                Comments

                Comment on this article