The Impact of Obesity on Kidney Disease: Observational Cohort Study Analyzing 14,492 Kidney Biopsy Casesopen access
- Authors
- Kim, Tae-Bum; Ahn, Shin Young; Oh, Jieun; Bae, Eun Hui; Chin, Ho Jun; Kim, Myung-Gyu; Jo, Sang Kyung; Cho, Won Yong; Oh, Se Won
- Issue Date
- Jan-2024
- Publisher
- 대한의학회
- Keywords
- Chronic Kidney Disease; End Stage Kidney Disease; Glomerular Disease; Kidney Biopsy; Obesity; Obesity-Related Glomerulopathy
- Citation
- Journal of Korean Medical Science, v.39, no.3
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Journal of Korean Medical Science
- Volume
- 39
- Number
- 3
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65800
- DOI
- 10.3346/jkms.2024.39.e12
- ISSN
- 1011-8934
1598-6357
- Abstract
- Background: The obesity epidemic is associated with the emergence of new kidney diseases including obesity-related glomerulopathy (ORG) and metabolic syndrome-associated disorders. However, the effects of obesity on prevalence and outcome of biopsy-proven kidney disease are not well known. Methods: We analyzed 14,492 kidney biopsies in 18 hospitals from 1979 to 2018 in Korea. Obesity was defined as a body mass index value of >= 30 kg/m2. Results: The most common disease was IgA nephropathy (IgAN) in both obese and nonobese participants (33.7% vs. 38.9%). Obesity was associated with a higher risk of focal segmental glomerulosclerosis (FSGS) and hypertensive nephropathy (HT-N) (odds ratio [OR], 1.72, 95% confidence interval [CI], 1.37-2.17; OR, 1.96, 95% CI, 1.21-3.19) and a lower risk of IgAN (OR, 0.74, 95% CI, 0.62-0.88). During the median follow up of 93.1 +/- 88.7 months, obesity increased the risk of end-stage kidney disease (ESKD) in patients with IgAN (relative risk [RR], 1.49, 95% CI, 1.01-2.20) and lupus nephritis (LN) (RR, 3.43, 95% CI, 1.36-8.67). Of 947 obese individuals, ORG was detected in 298 (31.5%), and 230 participants had other kidney diseases, most commonly, IgAN (40.9%) followed by diabetic nephropathy (15.2%). Participants with ORG, when combined with other renal diseases, showed higher risks for developing ESKD compared to those with ORG alone (RR, 2.48, 95% CI, 1.09-5.64). Conclusion: Obesity is associated with an increased risk of FSGS and HT-N, and also increase the ESKD risk in IgAN and LN patients. ORG in obese participants may have favorable renal outcomes if it occurs alone without any other renal disease.
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