Is there an association between obesity and renal function in a hypertensive Nigerian population? A cross-sectional study

Authors

  • Norbert Ndubuisi Unamba DEPARTMENT OF INTERNAL MEDICINE UPTH PORT HARCOURT
  • Richard Ishmael Oko-Jaja DEPARTMENT OF INTERNAL MEDICINE UPTH PORT HARCOURT

Keywords:

Obesity, chronic kidney disease, Nigerian, renal function, Hypertensive

Abstract

Background: Obesity has become a worldwide epidemic and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for chronic kidney disease (CKD). Obesity is one of the strongest risk factors for new-onset CKD. The aim of this study was to determine whether there was any association between the markers of adiposity and renal function in a Nigerian Adult population in hypertensive patients.

Methods: 144 Hypertensive subjects and 72 age- and sex-matched controls were recruited. Their waist circumference, body mass indices, and fasting lipid profile were determined. Diabetics were excluded from the study. Multiple logistic models were constructed to elucidate the independent determinants of eGFR.

 Results:  The mean waist circumference of the hypertensive patients was 97.51±11.9cm while that of the control group was 86.11±18.5cm (p<0.0001). 50% of the entire study population was obese with males making up to 20.6% and the females 74.4% (p<0.001).       Most of the obese subjects were in more advanced stages of CKD when compared with those who were non-obese (p=0.043)

When binary logistic regression analysis of the whole population was performed waist circumference was predictive of renal function: waist circumference 1.10 (1.01-1.20), (p=0.029).

 Conclusion: There was a significantly positive association between central obesity and renal function decline.  It can be used to predict the pathogenesis of CKD, which may be independent blood pressure levels.

Author Biographies

Norbert Ndubuisi Unamba, DEPARTMENT OF INTERNAL MEDICINE UPTH PORT HARCOURT

CONSULTANT CARDIOLOGIST

Richard Ishmael Oko-Jaja, DEPARTMENT OF INTERNAL MEDICINE UPTH PORT HARCOURT

CONSULTANT NEPHROLOGIST

References

Collaborators GBDRF, Forouzanfar MH, Alexander HR, Bachman VF, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386 (10010): 2287-2323.

Centers for Disease Control and Prevention (CDC). National chronic kidney disease fact sheet: general information and national estimates on chronic kidney disease in the United States, 2014. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2014.

Chang A, Van Horn L, Jacobs DR Jr., Liu K, Munter P, et al. Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study. Am J Kidney Dis. 2013; 62(2): 267-275.

Foster MC, Hwang SJ, Larson MG, Lichtman JH, Parikh NI, et al. Overweight, obesity, and the development of stage 3 CKD: the Framingham Heart Study. Am J Kidney Dis. 2008; 52(1):39-48.

Gelber RP, Kurth T, Kausz AT, Manson JE, Levey AS, et al. Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis. 2005; 46(5): 871-880.

Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D. Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-up Program. Am J Kidney Dis. 2005; 46(4): 387-594.

Lu JL, Kalantar-Zadeh K, Ma JZ, Quaries LD, Kovesdy CP. Association of body mass index with outcomes in patients withCKD. J Am Soc Nephrol. 2014; 25(9): 2088-2096.

Munkhaugen J, Lydersen S, Wideroe TE, Hallan S. Prehypertension, obesity, and risk of kidney disease: 20-year follow-up of the HUNT 1 study in Norway. Am J Kidbey Dis. 2009; 54(4): 638-646.

Vivante A, Golan E, Tzur D, Leiba A, Tirosh A, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med. 2012; 172(21): 1644-1650.

Ting SM, Nair H, Ching I, et al. Overweight, obesity and chronic kidney disease. Nephron Clin Pract 2000; 112:c121–127.

Garland JS. Elevated body mass index as a risk factor for chronic kidney disease: current perspectives. Diabetes Metab Syndr Obes 2014; 7: 347–355.

Kurella M, Lo JC, Chertow GM. Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 2005; 16:2134–2140.

Kramer H, Tuttle KR, Leehey D, et al. Obesity management in adults with CKD. Am J Kidney Dis 2009; 53:151–165.

Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, et al. Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int.2004; 65: 1870-1876.

Kalantar-Zadeh K, Kopple JD. Body mass index and risk for end-stage renal disease. Ann Intern Med 2006; 144: 701-702.

Herrington WG, Smith M, Bankhead C, Matsushita K, Stevens S, et al. Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. . PLoS ONE 12(3): e0173515. Doi: 10.1371/journal. pone.0173515

Noori N, Hosseinpanah F, Nasiri AA, et al. Comparison of overall obesity and abdominal adiposity in predicting chronic kidney disease incidence among adults. J Ren Nutr 2009; 19:228–37.

Elsayed EF, Tighiouart H, Weiner DE, et al. Waist-to-hip ratio and body mass index as risk factors for cardiovascular events in CKD. Am J Kidney Dis 2008; 52:49–57.

Elsayed EF, Sarnak MJ, Tighiouart H, et al. Waist-to-hip ratio, body mass index, and subsequent kidney disease and death. Am J Kidney Dis 2008; 52:29–38.

Ogedegbe G, Pickering T. Principles and techniques of blood pressure measurement. Cardiol Clin. 2010 Nov; 28(4): 571–586.doi: 10.1016/j.ccl.2010.07.006

Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31–34.

National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39:S1–266.

Oh H, Quan SA, Jeong J-Y, Jang S-N, Lee JE, Kim D-H. Waist circumference, not body mass index, is associated with renal function decline in Korean population: Hallym Aging study. PloS ONE 8(3): e59071. Doi: 10.1371/journal.pone.0059071.

Stefansson VTN, Schei J, Jenssen TG, Melsom T, Eriksen BO. Central obesity associates with renal hyperfiltration in the non-diabetic general population: a cross-sectional study. BMC Nephrology 2016; 17: 172.

Heneger JR, Bigler SA, Heneger LK. Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol. 2001; 12: 1211-1217.

Wolf G, Chen S, Han DC, Ziyadeh FN. Leptin and renal disease. Am J Kidney Dis. 2002; 39: 1-11.

Sharma K, Ramachandrarao S, Qiu G, et al. Adiponectin regulates albuminuria and podocyte function in mice. Journal of Clinical Investigation. 2008; 118: 1645-1656.

Hall ME, do Carmo JM, da Silva AA, Juncos LA, Wang Z, Hall JE. Obesity, hypertension, and chronic kidney disease. International Journal of Nephrology and Renovascular Disease 2014; (7):75–88.

Hall JE, da Silva AA, do Carmo JM, et al. Obesity-induced hypertension: role of sympathetic nervous system, leptin, and melanocortins. J Biol Chem. 2010; 285(23):17271–17276.

Cohen E, Fraser A, Goldberg E, Milo G, Garty M, Krause I. Association between the body mass index and chronic kidney disease in men and women. A population-based study from Israel. Nephrol Dial Transplant (2013) 28 (Suppl. 4): iv130–iv135 doi: 10.1093/ndt/gft072

de Vries AP, Ruggenenti P, Ruan XZ, Praga M, Cruzado JM, Bajema IM, et al. Fatty kidney: Emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol. 2014; 2:417–426.

Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS. Fatty kidney, hypertension, and chronic kidney disease: The Framingham Heart Study. Hypertension. 2011;58:784–790

Knight SF, Quigley JE, Yuan J, Roy SS, Elmarakby A, Imig JD. Endothelial dysfunction and the development of renal injury in spontaneously hypertensive rats fed a high-fat diet. Hypertension. 2008; 51:352–359.

Chang SH, Beason TS, Hunleth JM, Colditz GA. A systematic review of body fat distribution and mortality in older people. Maturitas.2012;72(3):175–191. doi:10.1016/j.maturitas.2012.04.004

Gallagher D, Visser M, De Meersman RE, Sepúlveda D, Baumgartner RN, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol. 1997; 83:229–239. doi: 10.1152/jappl.1997.83.1.229.

Downloads

Published

2020-04-22

How to Cite

Unamba, N. N., & Oko-Jaja, R. I. (2020). Is there an association between obesity and renal function in a hypertensive Nigerian population? A cross-sectional study. The Nigerian Health Journal, 18(4), 157–166. Retrieved from https://tnhjph.com/index.php/tnhj/article/view/388

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.