A community-based cross-sectional and longitudinal study uncovered asymptomatic proteinuria in Japanese adults with low body weight

Abstract

Although proteinuria is highly prevalent in obese individuals, the association between proteinuria and low body weight is equivocal. In this study we determine whether low body weight is more strongly associated with proteinuria compared with normal weight. The association between body mass index (BMI) and proteinuria was examined in a cross-sectional study of 62,582 asymptomatic individuals aged 20-70 years without known kidney diseases recruited, based on the results of medical checkups in 1999. We also examined the incidence of recurrent or nonrecurrent proteinuria in an 8-year longitudinal analysis of 12,493 individuals without proteinuria at baseline. The prevalence of proteinuria showed a J-shaped relationship with BMI. Multivariate regression analysis showed that BMI of 27.0 kg/m(2) and above or 18.9 kg/m(2) and less was significantly associated with proteinuria relative to BMI 21.0-22.9 kg/m(2), even after adjusting for relevant cardiometabolic risk factors. In the longitudinal study, similar J-shaped relationships between the incident rates of proteinuria and baseline BMI groups were observed at post-baseline checkups. Baseline BMI 27.0 kg/m(2) and above was associated with significantly greater risk for recurrent and nonrecurrent proteinuria, whereas BMI 18.9 kg/m(2) and less was only associated with nonrecurrent proteinuria. Thus, obesity and low body weight may be associated with different types of proteinuria independent of cardiometabolic risk factors.

Potential Association between Breakfast Skipping and Concomitant Late-Night-Dinner Eating with Metabolic Syndrome and Proteinuria in the Japanese Population

“…A growing body of clinical evidence has revealed that proteinuria, including albuminuria, is much more common in obese individuals than in normal-weight individuals [18–20]. However, our recent study [36] and a study by Sato et al [37] showed that low-body-weight individuals may also be at increased risk of proteinuria, relative to normal-weight individuals. The currently observed association between proteinuria and habitual breakfast skipping is therefore not surprising.…”

Underweight Is an Independent Risk Factor for Renal Function Deterioration in Patients with IgA Nephropathy

“…Moreover, Muneyuki et al . [38] indicated that the U-shape association between BMI and proteinuria were independent of traditional cardiometabolic risk factors. Since low or high BMI is related to higher proteinuria risk and mortality, we reckoned that underweight might participate in renal disease progression in IgAN patients.…”

Prevalence, awareness and treatment of chronic kidney disease among middle‐aged and elderly: The China Health and Retirement Longitudinal Study

“…32 Within our study, the prevalence of CKD in the urban definitely increased with economic levels, whereas, it was also very large in underdeveloped rural areas, possibly due to its higher proportion of malnutrition indicators, such as anaemia and underweight (15%, 12% for rural; 11%, 7% for urban). 33,34 Confronted with the characteristics above, the control of the risk factors should be strengthened to curb the potential upward shift. 35 Meanwhile, enough attention should also be paid to underdeveloped rural area, which roughly equal to a quarter of the population aged 45 years and above.…”

“…47 J-shaped relationships between BMI and risk of CKD were observed in this study, similar to the results from the longitudinal Japanese study with the outcome of proteinuria. 34 The clinical relevance and underlying mechanism of CKD in people with low body weight remains to be elucidated in future studies.…”