Obesity, anthropometric measures and chronic kidney disease complications.

OBJECTIVE

Anthropometric measures such as body mass index (BMI) and waist circumference (WC) have differential associations with incident chronic kidney disease (CKD) and mortality. We examined the associations of BMI and WC with various CKD complications.

METHODS

We conducted a cross-sectional analysis of 2,853 adult participants with CKD in the National Health and Nutrition Examination Surveys 1999-2006. The associations of BMI and WC (both as categorical and continuous variables) with CKD complications such as anemia, secondary hyperparathyroidism, hyperphosphatemia, metabolic acidosis, hypoalbuminemia and hypertension were examined using logistic regression models while adjusting for relevant confounding variables.

RESULTS

When examined as a continuous variable, an increase in BMI by 2 points and in WC by 5 cm was associated with higher odds of secondary hyperparathyroidism, hypoalbuminemia and hypertension among those with CKD. CKD participants with BMI ≥30 have higher odds of hypoalbuminemia and hypertension than those with BMI <30. CKD participants with high WC (>102 cm in men and >88 cm in women) have higher odds of hypoalbuminemia and hypertension and lower odds of having anemia than those with low WC. CKD participants with BMI <30 and high WC (vs. BMI <30 and low WC) were not associated with any increase in CKD complications.

CONCLUSIONS

Anthropometric measures such as BMI and WC are associated with secondary hyperparathyroidism, hypoalbuminemia and hypertension among adults with CKD. Higher WC among those with BMI <30 is not associated with CKD complications.