A RECENT multicentre study has found that adults with class II to III obesity face an increased risk of poor cardiac outcomes, though they do not have a higher risk for kidney complications after adjusting for potential confounders.
“Obesity is an increasingly prevalent risk factor for the development and progression of both chronic kidney disease (CKD) and cardiovascular disease (CVD),” explained lead author on the study, Evan Zeitler, University of North Carolina at, Chapel Hill, USA. “Patients with glomerular disease [GN] are also at higher risk of CKD and CVD than the general population, but whether obesity contributes to this increased risk is not known.”
The study analysed data from 2,301 patients (1,548 adults and 753 children) who were at least five years old at the time of enrolment. These patients were categorized into adult BMI groups and paediatric BMI percentiles. The primary outcomes measured were a kidney composite (40% decline in estimated glomerular filtration rate [eGFR] or kidney failure) and a cardiovascular composite (myocardial infarction, stroke, heart failure, or death).
In univariable analysis, class II to III obesity was linked to increased cardiovascular events in adults. The incidence rate was 19.7 cardiovascular events per 1,000 person-years for those with severe obesity. However, when adjustments were made for baseline eGFR and proteinuria in the multivariable analysis, severe obesity was not significantly associated with kidney outcomes.
The study revealed an incidence rate of 90.8 kidney events per 1,000 person-years in adults, compared to 58 per 1,000 person-years among normal weight individuals. Despite the initial association in the univariable analysis, the adjusted results indicated no significant tie between severe obesity and kidney outcomes.
“This study contributes to the evidence that obesity adversely affects the clinical course of patients with GN, highlighting the need for further research into mechanisms underlying this association and interventions targeted at reducing its impact,” the researchers concluded.
Zeitler and team emphasised the potential of using standardized pathology scoring and existing bio-samples to further explore the interaction between obesity and glomerular disease, as well as the progression of CKD.
Reference
Zeitler E et al. Association of obesity with kidney and cardiac outcomes among patients with glomerular disease: findings from the cure glomerulonephropathy network. Am J Kid Dis. 2024; S0272-6386(24)00756-X.
