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283 Perspectiva Obesity and kidney disease - C. P. Kovesdy et al Table 1. Studies examining the association of obesity with various measures of CKD Study Patients Exposure Outcomes Results Comments Prevention of Renal and 7,676 Dutch individuals Vascular End-Stage without diabetes Disease (PREVEND) Study8 Elevated BMI (overweight and obese*), and central fat distribution (waist-hip ratio) - Presence of urine albumin 30-300 mg/24 h - Elevated and diminished GFR - Obese + central fat: higher risk of albuminuria - Obese +/- central fat: higher risk of elevated GFR - Central fat +/- obesity associated with diminished filtration Cross sectional analysis Multinational study of hypertensive outpatients20 20,828 patients from 26 countries BMI and waist circumference Prevalence of albuminuria by dip stick Higher waist circumference associated with albuminuria independent of BMI Cross sectional analysis Framingham Multi- Detector Computed Tomography (MDCT) cohort22 3,099 individuals Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) Prevalence of UACR > 25 mg/g in women and > 17 mg/g in men VAT associated with albuminuria in men, but not in women Cross sectional analysis CARDIA (Coronary Artery Risk Development in Young Adults) study11 2,354 communitydwelling individuals with normal kidney function aged 28-40 years - Obesity (BMI > 30 kg/m2) - Diet and lifestyle- related factors Incident microalbuminuria Obesity (OR 1.9) and unhealthy diet (OR 2.0) associated with incident albuminuria Low number of events Hypertension Detection and Follow-Up Program10 5,897 hypertensive adults Overweight and obese BMI* vs normal BMI Incident CKD (1+ or greater proteinuria on urinalysis and/or an eGFR < 60 mL/min/ 1.73 m2) Both overweight (OR 1.21) and obesity (OR 1.40) associated with incident CKD Results unchanged after excluding diabetics Framingham Offspring Study9 2,676 individuals free of CKD stage 3 High vs normal BMI* - Incident CKD stage 3 - Incident proteinuria - Higher BMI not associated with CKD3 after adjustments - Higher BMI associated with increased odds of incident proteinuria Predominantly white, limited geography Physicians’ Health Study13 11,104 initially healthy men in US - BMI quintiles - Increase in BMI over time (vs stable BMI) Incident eGFR < 60 mL/min/1.73 m2 - Higher baseline BMI and increase in BMI over time both associated with higher risk of incident CKD Exclusively men Rev Med Chile 2017; 145: 281-291


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