High body mass index was associated with an additional annual eGFR decline of -0.35 ml/min/1.73 m2 (95% CI -0.56 to -0.14) per 5 kg/m2 increment in men post-myocardial infarction.
Cohort (n=2,410)
Mean Difference: -0.35 (95% CI -0.56–-0.14)
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.
Esmeijer et al. (Thu,) conducted a cohort in Post-myocardial infarction (n=2,410). High body mass index and waist circumference vs. Normal body mass index and waist circumference was evaluated on Annual eGFR cysC decline (MD -0.35, 95% CI -0.56 to -0.14). High body mass index was associated with an additional annual eGFR decline of -0.35 ml/min/1.73 m2 (95% CI -0.56 to -0.14) per 5 kg/m2 increment in men post-myocardial infarction.