Association of Body Mass Index with Estimated Glomerular Filtration Rate and Incident Proteinuria

摘要

Obesity has been one of the most important risk factors of chronic kidney disease (CKD). But the association of body mass index (BMI) with estimated glomerular filtration rate (eGFR) and incident proteinuria has not been studied well. The goal of this study was to elucidate the association of BMI with eGFR and proteinuria using nationwide health examination data. These associations were investigated with data of Korean adults who had undergone health screenings at least three times between 2009 and 2014. eGFR was calculated with Chronic Kidney Disease Epidemiology collaboration equation based on serum creatinine level. The association between BMI and eGFR was analysed with a generalized addictive model adjusting for possible confounders. Similarly, the association between BMI and incident proteinuria was analysed with Cox hazard model adjusting for possible confounders. As a result, a V-shape relationship between BMI and eGFR was observed. The nadir was around 29 kg/m~2. With subgroup analyses for the association between BMI and eGFR, a V-shape association was observed in men and younger age group and an inverse association was observed in women and older age group. A reverse J-shape association between BMI and the adjusted hazard ratio of incident proteinuria was observed. The nadir was approximately estimated around 22 kg/m~2.