Differential Prognostic Utility of Adiposity Measures in Chronic Kidney Disease

Cejka V, Störk S, Nadal J, Schmid M, Sommerer C, Sitter T, Meiselbach H, Busch M, Schneider M, Saritas T, Schultheiss UT, Kotsis F, Wanner C, Eckardt KU, Krane V, Schiffer M, Prokosch HU, Bärthlein B, Beck A, Reis A, Ekici AB, Becker S, Becker-Grosspitsch D, Alberth-Schmidt U, Hausknecht B, Weigel A, Walz G, Köttgen A, Meder S, Mitsch E, Reinhard U, Floege J, Schaeffner E, Baid-Agrawal S, Theisen K, Haller H, Zeier M, Theilinger J, Wolf G, Paul R, Börner-Klein A, Bauer B, Kronenberg F, Raschenberger J, Kollerits B, Forer L, Schönherr S, Weissensteiner H, Oefner P, Gronwald W (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Journal of Renal Nutrition WB Saunders

Book Volume: 33

Pages Range: 546-554

Journal Issue: 4

DOI: 10.1053/j.jrn.2023.04.006

Abstract

Objective: Adipose tissue contributes to adverse outcomes in chronic kidney disease (CKD), but there is uncertainty regarding the prognostic relevance of different adiposity measures. We analyzed the associations of neck circumference (NC), waist circumference (WC), and body mass index (BMI) with clinical outcomes in patients with mild to severe CKD. Methods: The German Chronic Kidney Disease study is a prospective cohort study, which enrolled Caucasian adults with mild to severe CKD, defined as estimated glomerular filtration rate : 30-60 mL/min/1.73 m2, or >60 mL/min/1.73 m2 in the presence of overt proteinuria. Associations of NC, WC, and BMI with all-cause death, major adverse cardiovascular events (MACE: a composite of nonfatal stroke, nonfatal myocardial infarction, peripheral artery disease intervention, and cardiovascular death), and kidney failure (a composite of dialysis or transplantation) were analyzed using multivariable Cox proportional hazards regression models adjusted for confounders and the Akaike information criteria were calculated. Models included sex interactions with adiposity measures. Results: A total of 4537 participants (59% male) were included in the analysis. During a 6.5-year follow-up, 339 participants died, 510 experienced MACE, and 341 developed kidney failure. In fully adjusted models, NC was associated with all-cause death in women (hazard ratio 1.080 per cm; 95% CI 1.009-1.155) but not in men. Irrespective of sex, WC was associated with all-cause death (hazard ratio 1.014 per cm; 95% CI 1.005-1.038). NC and WC showed no association with MACE or kidney failure. BMI was not associated with any of the analyzed outcomes. Models of all-cause death, including WC offered the best (lowest) Akaike information criteria. Conclusion: In Caucasian patients with mild to severe CKD, higher NC (in women) and WC were significantly associated with increased risk of death from any cause but BMI was not.

Authors with CRIS profile

Heike Meiselbach Department of Medicine 4 – Nephrology and Hypertension Markus Schneider Department of Medicine 4 – Nephrology and Hypertension Kai-Uwe Eckardt Department of Medicine 4 – Nephrology and Hypertension

Involved external institutions

Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Universitätsklinikum Würzburg DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Klinikum der Universität München DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Universitätsklinikum Aachen (UKA) DE Germany (DE) Universitätsklinikum Freiburg DE Germany (DE)

How to cite

APA:

Cejka, V., Störk, S., Nadal, J., Schmid, M., Sommerer, C., Sitter, T.,... Gronwald, W. (2023). Differential Prognostic Utility of Adiposity Measures in Chronic Kidney Disease. Journal of Renal Nutrition, 33(4), 546-554. https://doi.org/10.1053/j.jrn.2023.04.006

MLA:

Cejka, Vladimir, et al. "Differential Prognostic Utility of Adiposity Measures in Chronic Kidney Disease." Journal of Renal Nutrition 33.4 (2023): 546-554.

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