Key result
Measures of abdominal obesity, including waist-to-hip ratio and skinfold thickness, are superior to BMI for predicting mortality and measuring body fat in patients with chronic kidney disease.
Why the study?
Do alternative obesity metrics (waist circumference, WHR, skinfold thickness, BIA) predict adverse outcomes and measure body fat better than BMI in patients with chronic kidney disease?
Do alternative obesity metrics (waist circumference, WHR, skinfold thickness, BIA) predict adverse outcomes and measure body fat better than BMI in patients with chronic kidney disease?
Alternative metrics of obesity such as waist circumference and WHR are better predictors of mortality and body fat than BMI in CKD patients, though their practical clinical advantage remains unproven.
Abdominal obesity metrics may refine mortality risk assessment in CKD beyond BMI; leaves open whether they should replace BMI in practice.
PURPOSE OF REVIEW: Obesity is a major driver of the current epidemic of chronic kidney disease (CKD), but metrics of obesity in the CKD population have been studied sparsely. This review updates knowledge on this issue. RECENT FINDINGS: Measures of abdominal obesity, waist circumference and waist-to-hip ratio (WHR), are better predictors than BMI of the high risk of mortality in predialysis and dialysis patients and waist circumference reliably reflects visceral fat in CKD patients. Skinfold thickness and WHR are superior to BMI for the classification of obesity in CKD patients. Multifrequency body impedance analysis (BIA) provides valid estimates of fat mass in hemodialysis patients. SUMMARY: Skinfold thickness,WHR and multifrequency BIA are superior to BMI for measuring body fat in CKD patients and measures of abdominal obesity are stronger predictors of adverse clinical outcomes than the BMI. These metrics should be preferentially applied for the assessment of obesity in CKD, but it remains unproven that these techniques offer real advantages over the BMI in clinical practice in CKD patients.
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Zoccali et al. (2012) conducted a review in Chronic kidney disease (CKD). Measures of abdominal obesity (waist circumference, waist-to-hip ratio, skinfold thickness, BIA) vs. Body Mass Index (BMI) was evaluated on Mortality and adverse clinical outcomes. Measures of abdominal obesity, including waist-to-hip ratio and skinfold thickness, are superior to BMI for predicting mortality and measuring body fat in patients with chronic kidney disease.
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