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Publication Information
Affiliation
Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Kristen.Nowak@ucdenver.edu.; Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.; Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.; Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.; Section of Nephrology, University of Chicago, Chicago, Illinois.; Division of Nephrology, Tufts University Medical Center, Boston, Massachusetts.; Department of Medicine and Renal Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Center for Clinical Trials & Data Coordination, Division of General Internal Medicine, and.; Division of Renal Medicine, Emory University School of Medicine, Atlanta, Georgia; and.; Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, Kansas.; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.; Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania.; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.; Division of Nephrology, Tufts University Medical Center, Boston, Massachusetts.; Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Authors
Nowak Kristen L, You Zhiying, Gitomer Berenice, Brosnahan Godela, Torres Vicente E, Chapman Arlene B, Perrone Ronald D, Steinman Theodore I, Abebe Kaleab Z, Rahbari-Oskoui Frederic F, Yu Alan S L, Harris Peter C, Bae Kyongtae T, Hogan Marie, Miskulin Dana, Chonchol Michel
Studies
Abstract
The association of overweight/obesity with disease progression in patients with autosomal dominant polycystic kidney disease (ADPKD) remains untested. We hypothesized that overweight/obesity associates with faster progression in early-stage ADPKD. Overall, 441 nondiabetic participants with ADPKD and an eGFR>60 ml/min per 1.73 m2 who participated in the Halt Progression of Polycystic Kidney Disease Study A were categorized on the basis of body mass index (BMI; calculated using nonkidney and nonliver weight) as normal weight (18.5-24.9 kg/m2; reference; n=192), overweight (25.0-29.9 kg/m2; n=168), or obese (≥30 kg/m2; n=81). We evaluated the longitudinal (5-year) association of overweight/obesity with change in total kidney volume (TKV) by magnetic resonance imaging using linear regression and multinomial logistic regression models. Among participants, mean±SD age was 37±8 years, annual percent change in TKV was 7.4%±5.1%, and BMI was 26.3±4.9 kg/m2 The annual percent change in TKV increased with increasing BMI category (normal weight: 6.1%±4.7%, overweight: 7.9%±4.8%, obese: 9.4%±6.2%; P<0.001). In the fully adjusted model, higher BMI associated with greater annual percent change in TKV (β=0.79; 95% confidence interval [95% CI], 0.18 to 1.39, per 5-unit increase in BMI). Overweight and obesity associated with increased odds of annual percent change in TKV ≥7% compared with <5% (overweight: odds ratio, 2.02; 95% CI, 1.15 to 3.56; obese: odds ratio, 3.76; 95% CI, 1.81 to 7.80). Obesity also independently associated with greater eGFR decline (slope) versus normal weight (fully adjusted β =-0.08; 95% CI, -0.15 to -0.02). In conclusion, overweight and, particularly, obesity are strongly and independently associated with rate of progression in early-stage ADPKD.