Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mas...Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.展开更多
The kidney is the water and fire zang-organ which contains kidney-yin and kidney-yang. The waist is a house of the kidney where channels and collaterals are vertically and horizontally distributed. The Bladder Channel...The kidney is the water and fire zang-organ which contains kidney-yin and kidney-yang. The waist is a house of the kidney where channels and collaterals are vertically and horizontally distributed. The Bladder Channel of Foot-Taiyang is distributed on the back in 4 lines; the Belt Channel surrounds the waist region controlling the various channels; and the straight portion of the Kidney Channel展开更多
文摘Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.
文摘The kidney is the water and fire zang-organ which contains kidney-yin and kidney-yang. The waist is a house of the kidney where channels and collaterals are vertically and horizontally distributed. The Bladder Channel of Foot-Taiyang is distributed on the back in 4 lines; the Belt Channel surrounds the waist region controlling the various channels; and the straight portion of the Kidney Channel