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BMC Nephrology

, 17:172

Epidemiology and Health Outcomes

Abstract

BackgroundObesity is a risk factor for end-stage renal disease. Renal hyperfiltration, defined as an abnormally high glomerular filtration rate GFR, is a link in the causal chain between diabetes and chronic kidney disease. Whether obesity is associated with hyperfiltration in the non-diabetic general population, remains unresolved due to a lack of consensus regarding the definition of hyperfiltration and the limited precision of high-range GFR estimations with creatinine and-or cystatin C.

Methods1555 middle-aged participants without diabetes, renal or cardiovascular disease were enrolled from the general population in the Renal Iohexol Clearance Survey from the 6th Tromsø Study RENIS-T6 between 2007 and 2009. Obesity was assessed using the body mass index BMI, waist circumference WC and the waist-hip ratio WHR. GFR was measured by iohexol clearance. Dichotomous variables for hyperfiltration were based on two alternative definitions using unadjusted GFR mL-min above the 90th percentile. The 90th percentile was age-, sex- and height-specific in one definition and age-, sex-, height- and weight-specific in the other.

ResultsIn multivariable adjusted logistic regression models, only WHR was consistently associated with hyperfiltration based on both definitions. For the definition based on the age-, sex-, height- and weight-specific 90th percentile, the association with the WHR odds ratios 95 % confidence intervals for hyperfiltration was 1.48 1.08–2.02 per 0.10 WHR increase.

ConclusionsCentral obesity is associated with hyperfiltration in the general population. The WHR may serve as a better indicator of the renal effects of obesity than BMI or WC.

KeywordsBody mass index Chronic kidney disease Glomerular filtration rate Glomerular hyperfiltration Waist circumference Waist-hip ratio AbbreviationsBMIBody mass index

BPBlood pressure

BSABody surface area

CKDChronic kidney disease

ESRDEnd-stage renal disease

GFRGlomerular filtration rate

HOMA-IRHomeostatic model assessment of insulin resistance

mGFRMeasured glomerular filtration rate

RENIS-T6Renal Iohexol Survey in Tromsø 6

RHFRenal hyperfiltration

WCWaist circumference

WHRWaist-hip ratio

Electronic supplementary materialThe online version of this article doi:10.1186-s12882-016-0386-4 contains supplementary material, which is available to authorized users.

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Autor: Vidar Tor Nyborg Stefansson - Jørgen Schei - Trond Geir Jenssen - Toralf Melsom - Bjørn Odvar Eriksen

Fuente: https://link.springer.com/



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