Obesity phenotype and patient-reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study

Schweitzer, Marie laure; Stengel, Bénédicte; Legrand, Karine; Briançon, Serge; Jacquelinet, Christian; Combe, Christian; Fouque, Denis; Massy, Ziad A.; Laville, Maurice; Frimat, Luc; Ayav, Carole

doi:10.1007/s11136-019-02110-2

Cited by 13 publications

(9 citation statements)

References 41 publications

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“…Some potential mechanisms may explain the synergetic effect of hypertension and diabetes on new‐onset CKD. Firstly, participants with hypertension or diabetes were more likely to complicate with underlying health problems, such as metabolic diseases and obesity, which were also observed in our study, contributing to the progress of nephropathy . It was also reported that diabetic patients with hypertension were more likely to have a peripheral arterial resistance and the resistant hypertension increased the risk of end‐stage renal diseases by at least 2.6‐fold .…”

Section: Discussionsupporting

confidence: 64%

The effects of hypertension and diabetes on new‐onset chronic kidney disease: A prospective cohort study

Wang

et al. 2019

J of Clinical Hypertension

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The study aimed to determine the different status of hypertension and diabetes on the risk of new‐onset chronic kidney disease (CKD) events in Kailuan Study. A total of 21 905 individuals were enrolled in the study. The new‐onset incidents of CKD, hypertension, and diabetes were collected in the follow‐ups. All the individuals were divided into five groups according to baseline and follow‐up hypertension and diabetes status: baseline hypertension (BH), baseline hypertension and incidence of diabetes (BHID), baseline diabetes (BD), baseline diabetes and incidence of hypertension (BDIH), and baseline hypertension and diabetes (BHD). The risk of new‐onset CKD of the five groups was calculated using the Cox regression analysis. In the median follow‐up of 7.05 ± 2.59 years, the prevalence of new‐onset CKD in the group of BH, BHID, BD, BDIH, and BHD were 27.1, 43.79, 25.4, 36.6, and 45.1 per 1000 years, respectively. When adjusted possible confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) of new‐onset CKD were 1.50 (95% CI: 1.38‐1.63), 1.25(95% CI: 1.07‐1.47), and 1.52 (95% CI: 1.35‐1.7) in the group of BHID, BDIH, and BHD, respectively, as referred to the BH group (P < .001). No obvious difference was observed in the group of BH and BD for the incidence of new‐onset CKD. Sensitivity analysis still showed the similar results among the five groups. The study showed that the effect of simple hypertension or simple diabetes on new‐onset CKD was not significantly different, but the incidence of new‐onset hypertension or diabetes increased the risk of new‐onset CKD. Hypertension and diabetes had a synergistic influence on the risk of new‐onset CKD.

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Section: Discussionsupporting

confidence: 64%

The effects of hypertension and diabetes on new‐onset chronic kidney disease: A prospective cohort study

Wang

et al. 2019

J of Clinical Hypertension

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“…As in AH, DM treatment is also commonly performed with drug associations [44], partially explaining the observed association between PDI and DM. Although the pathophysiology associated with refractoriness to pharmacological treatment of DM in the severely obese is still unknown, in some cases, it may be caused by impaired pharmacokinetics and the bioavailability of drugs because of changes in the volume of distribution [45], the liver [9], and renal function [46]. It is suggested that adequate glycemic control may not be achieved due to the exposure of sub-therapeutic doses, which leads to the addition of other drugs to the therapeutic regimen [44], which, consequently, increases the possibility of the occurrence of PDI.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Drug Interaction in Severely Obese Individuals and Associated Factors: Baseline Results from a Clinical Trial

et al. 2020

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The prevalence of obesity is increasing worldwide and is commonly associated with comorbidities. The use of several drugs is often necessary, which leads to Potential Drug Interactions (PDI) that may increase the morbidity and mortality. This study aimed to analyze the prevalence of drug interaction and its association with socio-demographics, health status, and drug use in severely obese individuals. Baseline data from a randomized clinical trial registered at Clinicaltrial.gov (NCT02463435) were used. A total of 150 individuals aged 18–65 years with a body mass index of 35 kg/m2 were included. The outcome variable was the presence of PDI, and the explanatory variables were divided into the following four levels: socio-demographic, lifestyle, health, and medication use. The prevalence of PDI was 50% (n = 75) (95% CI 41–58). The variables associated with drug–drug interactions in the multiple analyses were arterial hypertension (PR 1.83, 95%, CI 1.10–3.04), polypharmacy (PR 3.12, 95%, CI 2.17–4.50), and diabetes mellitus (PR 0.60, 95%, CI 0.45–0.81). The risk factors for the occurrence of drug interaction were the presence of diabetes mellitus, hypertension, and polypharmacy.

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“…A recent study in Sri Lanka identified level of education, employment status, stage of CKD, dialysis treatment, and presence of co-morbidities as significant predictors of symptom burden [35], and low income and physical and psychological burden as independent predictors of low HRQOL [37] in a CKD/CKDu population. Age, gender, economic status, comorbid medical conditions, stage and duration of kidney disease, body mass index (BMI), and physical activity (PA) were all recorded as possible determinants of HRQOL of CKD patients [38][39][40][41]. On account of the various negative impacts of CKDu on the physical, psychological, and social wellbeing of patients, the disease can be a cause of devastation not only in patients but also their families and relevant agricultural societies.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka

Abeywickrama

Wimalasiri

Koyama

et al. 2020

IJERPH

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Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.

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Obesity phenotype and patient-reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study

Cited by 13 publications

References 41 publications

The effects of hypertension and diabetes on new‐onset chronic kidney disease: A prospective cohort study

The effects of hypertension and diabetes on new‐onset chronic kidney disease: A prospective cohort study

Prevalence of Drug Interaction in Severely Obese Individuals and Associated Factors: Baseline Results from a Clinical Trial

Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka

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