Key result
Higher BMI is linked to ~0.35 ml/min/1.73 m2 faster annual eGFR decline per 5 kg/m2.
Why the study?
Does obesity or high waist circumference accelerate kidney function decline in older stable post-myocardial infarction patients?
Cohort (n=2,410)
Does obesity or high waist circumference accelerate kidney function decline in older stable post-myocardial infarction patients?
In older, stable post-myocardial infarction patients, obesity and high waist circumference are associated with a more rapid decline in kidney function over time.
Answers are grounded in this paper and cite their sources.
May warrant closer renal monitoring in obese post-MI patients; leaves open whether weight loss slows eGFR decline.
Background Obesity increases risk of hypertension and diabetes, the leading causes of end-stage renal disease. The effect of obesity on kidney function decline in stable post-myocardial infarction patients is poorly documented. This relation was investigated in a large cohort of older post-myocardial infarction patients. Design Data were analysed from 2410 post-myocardial infarction patients in the Alpha Omega Trial, aged 60–80 years receiving optimal pharmacotherapy treatment (79% men, 18% diabetes). Methods Cystatin C based estimated glomerular filtration rate (eGFR cysC ) was calculated at baseline and after 41 months, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Obesity was defined as body mass index ≥ 30 kg/m 2 and high waist circumference as ≥102 and ≥88 cm for men and women. The relation between body mass index, waist circumference and annual eGFR cysC decline was evaluated by linear regression. Results At baseline, mean (standard deviation) eGFR cysC was 81.5 (19.6) ml/min/1.73 m 2 , 23% of all patients were obese. After multivariable adjustment, the annual mean (95% confidence interval) eGFR cysC decline in men and women was –1.45 (–1.59 to –1.31) and –0.92 (–1.20 to –0.63) ml/min/1.73 m 2 , respectively ( p = 0.001). Obese versus non-obese patients and patients with high versus normal waist circumference experienced greater annual eGFR cysC decline. Men and women showed an additional annual eGFR cysC decline of –0.35 (–0.56 to –0.14) and –0.21 (–0.55 to 0.14) ml/min/1.73 m 2 per 5 kg/m 2 body mass index increment ( p for interaction 0.3). Conclusions High compared to normal body mass index or waist circumference were associated with more rapid kidney function decline in older stable post-myocardial infarction patients receiving optimal drug therapy.
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Esmeijer et al. (2017) conducted a cohort in Post-myocardial infarction (n=2,410). Higher body mass index (per 5 kg/m2 increment) vs. Lower body mass index was evaluated on Additional annual cystatin C-based estimated glomerular filtration rate (eGFRcysC) decline in men (MD -0.35, 95% CI -0.56 to -0.14). Each 5 kg/m2 increment in body mass index was associated with an additional annual kidney function decline of -0.35 ml/min/1.73 m2 in men and -0.21 ml/min/1.73 m2 in women with stable post-myocardial infarction.
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