Waist Circumference and Visceral Fat in CKD: A Cross-sectional Study

Sanches, Fabiana M. R.; Avesani, Carla María; Kamimura, Maria Ayako; Lemos, Marcelo M.; Axelsson, Jonas; Vasselai, Priscila; Draibe, Sérgio Antônio; Cuppari, Lílian

doi:10.1053/j.ajkd.2008.02.004

Cited by 109 publications

(71 citation statements)

References 31 publications

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“…Neither visceral nor subcutaneous fat mass differed according to sex (Table 2), but female sex was associated with visceral and subcutaneous obesity (Table 3). Those findings contrast with the results published by Sanches et al (17), who conducted a cross-sectional study in patients with non-dialysis chronic kidney disease, showing that visceral fat was greater in men than in women and that subcutaneous fat was greater in women.…”

Section: Discussioncontrasting

confidence: 99%

Does Body Fat Mass Define Survival in Patients Starting Peritoneal Dialysis?

et al. 2014

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♦ Background and Aims: Peritoneal dialysis (PD) is characterized by a gain in fat mass. Unlike subcutaneous fat, visceral fat is associated with metabolic syndrome and survival. We prospectively examined whether visceral or subcutaneous fat could predict outcome in patients undergoing PD. ♦ Methods: We studied 117 new patients (57 men) undergoing PD between February 2006 and November 2011. Baseline body composition was measured on computed tomograms. Visceral obesity was defined as a visceral fat area exceeding 100 cm 2 , and subcutaneous obesity, as a subcutaneous fat area exceeding 130 cm 2 . ♦ Results: Among the 117 patients, 37 and 29 were diagnosed with visceral and subcutaneous obesity respectively. Visceral and subcutaneous obesity were both present in 21 patients. In the study population, the 1-year and 5-year survival rates were 94% and 59%. The rates of peritonitis and exit-infection were 0.31 and 0.14 episodes per patient-year. Mortality was greater in patients with visceral obesity than in those without visceral obesity (p = 0.005). Visceral obesity had no influence on peritonitis and exit-infection rates. Subcutaneous obesity was associated neither with survival nor with peritonitis or exit-site infection. In a multivariate Cox regression analysis, visceral obesity was not a risk factor for poor outcome. ♦ Conclusions: Increased visceral fat at PD initiation is not an independent predictor of poor survival. Any impact of visceral or subcutaneous fat mass on outcomes in patients undergoing PD would be better defined by larger, longterm studies.Perit Dial Int 2014; 34(4):376-382 www.PDIConnect.com epub ahead of print:

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Section: Discussioncontrasting

confidence: 99%

Does Body Fat Mass Define Survival in Patients Starting Peritoneal Dialysis?

et al. 2014

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“…Singh et al [8] have observed positive association with BMI and renal impairment. Sanches et al [32] have shown correlation with WC and WHR with reduced GFR. Our study has shown similar correlations of these factors with CKD.…”

Section: Discussionmentioning

confidence: 94%

Prevalence of Early Stages of Chronic Kidney Disease in Healthy Army Personnel

Varma

Raman

Ramakrishnan³

et al. 2011

Medical Journal Armed Forces India

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“…Waistto-hip ratio is better than BMI at predicting future cardiovascular events and mortality in patients with CKD, as well as in transplant recipients, and it is superior for the detection of GFR loss in obese individuals. [54][55][56] Obesity is also known to limit access to transplantation 57 and may be the most important modifiable factor that can influence overall survival. 47 Many centers impose BMI restrictions secondary to increased morbidity around the time of transplantation and decreased patient and graft survival rates.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Renal Function on Outcomes of Bariatric Surgery

Turgeon

Perez

Mondestin³

et al. 2012

Journal of the American Society of Nephrology

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The effect of CKD on the risks of bariatric surgery is not well understood. Using the American College of Surgeons National Surgical Quality Improvement Program Participant Use File, we analyzed 27,736 patients who underwent bariatric surgery from 2006 through 2008. Before surgery, 34 (0.12%) patients were undergoing long-term dialysis. Among those not undergoing dialysis, 20,806 patients (75.0%) had a normal estimated GFR or stage 1 CKD, 5011 (18.07%) had stage 2 CKD, 1734 (6.25%) had stage 3 CKD, 94 (0.34%) had stage 4 CKD, and 91 (0.33%) had stage 5 CKD. In an unadjusted analysis, CKD stage was directly associated with complication rate, ranging from 4.6% for those with stage 1 CKD or normal estimated GFR to 9.9% for those with stage 5 CKD (test for trend, P,0.001). Multivariable logistic regression demonstrated that CKD stage predicts higher complication rates (odds ratio for each higher CKD stage, 1.30) after adjustment for diabetes and hypertension. Although patients with higher CKD stage had higher complication rates, the absolute incidence of complications remained ,10%. In conclusion, these data demonstrate higher risks of bariatric surgery among patients with worse renal function, but whether the potential benefits outweigh the risks in this population requires further study.

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Waist Circumference and Visceral Fat in CKD: A Cross-sectional Study

Cited by 109 publications

References 31 publications

Does Body Fat Mass Define Survival in Patients Starting Peritoneal Dialysis?

Does Body Fat Mass Define Survival in Patients Starting Peritoneal Dialysis?

Prevalence of Early Stages of Chronic Kidney Disease in Healthy Army Personnel

The Impact of Renal Function on Outcomes of Bariatric Surgery

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