Fat Mass Gain Predicts Estimated GFR Decline in a Relatively Healthy Korean Population

Abstract

Background: Previous studies have shown that obesity is a risk factor for estimated glomerular filtration rate (eGFR) decline and chronic kidney disease (CKD). However, the relationship between fat mass directly measured by bioimpedance analysis and eGFR is not well known. Methods: We analyzed 21,859 participants without CKD at baseline who underwent two health checkups at a 5-year interval during 2002-2009. Fat mass was measured by Inbody 3.0 (Biospace, Seoul, Korea). eGFR decline was defined as eGFR <60 ml/min/1.73 m² at second checkup. Logistic regression analysis was used to analyze factors related to eGFR decline. Results: Participants were divided into tertiles according to their fat mass change over 5 years: lower tertile (n = 7,042; <-0.7 kg), middle tertile (n = 7,478; -0.7 to 1.2 kg) and higher tertile (n = 7,339; >1.2 kg). After 5 years, 246 cases of eGFR decline were observed. Multivariate logistic analysis revealed that age (OR 1.03, 95% CI 1.02-1.05, p < 0.001), diabetes mellitus (OR 2.04, 95% CI 1.22-3.40, p = 0.007), baseline eGFR (OR 0.80, 95% CI 0.78-0.83, p < 0.001) and higher tertile of fat mass change (OR 1.58, 95% CI 1.16-2.13, p = 0.003) were associated with eGFR decline after adjustment for sex, hypertension, dyslipidemia, cardiovascular disease, smoking status, body mass index, and high-density lipoprotein cholesterol level. Conclusions: Fat mass gain over 5 years was independently associated with eGFR decline to <60 ml/min/1.73 m² in a relatively healthy Korean population. This finding suggests that lifestyle changes to prevent fat mass gain could be protective against the development of CKD.

Prevalence of obesity and risk of chronic kidney disease among young adults in Egypt

“…Moreover, another study observed decline in GFR in later life. [35] Such observation necessitates further work up to follow up GFR in all study populations and also necessitate weight reduction programs to minimize the risk of the gradual decline of renal functions.…”

Effects of age and sex on the relationship between body fat area and kidney events in patients with chronic kidney disease

“…The relationship between body fat and renal prognosis has been studied several times. Body fat mass gains measured by BIA are independently associated with a decrease of eGFR <60 mL/min/1.73 m 2 in a relatively healthy Korean population 4 . In CKD patients, the VFA‐to‐SFA ratio is a risk factor of reduced kidney function 8 .…”

“…Body fat mass gains measured by BIA are independently associated with a decrease of eGFR <60 mL/min/1.73 m 2 in a relatively healthy Korean population. 4 In CKD patients, the VFAto-SFA ratio is a risk factor of reduced kidney function. 8 However, this previous study had limited number of patients and did not consider age and sex.…”

“…Additionally, the growing obese population is a major health problem, worldwide. Recently, body fat has been evaluated using tools such as bioimpedance analysis (BIA), and there have been several reports of associations between body fat and kidney events 3,4 . However, it is less accurate in CKD patients because of water retention and effects of fluids 5 .…”

“…Recently, body fat has been evaluated using tools such as bioimpedance analysis (BIA), and there have been several reports of associations between body fat and kidney events. 3,4 However, it is less accurate in CKD patients because of water retention and effects of fluids. 5 Therefore, techniques capable of imaging body fat areas, such as computed tomography (CT), have received attention.…”