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Adiposity patterns and the risk for ESRD in postmenopausal women.
Clin J Am Soc Nephrol. 2015 Feb 06; 10(2):241-50.CJ

Abstract

BACKGROUND AND OBJECTIVES

Body mass index and waist circumference associate with adverse health outcomes, including CKD. Studies of the association of body mass index and ESRD have been inconsistent; these adiposity measures have not been previously assessed together for ESRD risk or among postmenopausal women.

DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS

This was prospective cohort study of 20,117 postmenopausal women enrolled in the multiethnic cohort of the Women's Health Initiative. Body mass index and waist circumference were obtained at baseline, incident ESRD was obtained from the US Renal Data System, and all-cause death was obtained from surveillance data. A competing-risk framework was used to account for the effect of mortality before ESRD while adjusting for significant predictors and baseline kidney function. Associations of adiposity with mortality were also studied.

RESULTS

Events included 212 patients with incident ESRD and 3104 deaths for a mean follow-up of 11.6 years. Increased waist circumference and body mass index were associated with 2.59- (95% confidence interval, 1.89 to 3.53) and 1.97-fold (95% confidence interval, 1.30 to 2.98) higher hazards of ESRD as well as 1.42- (95% confidence interval, 1.32 to 1.53) and 1.21-fold (95% confidence interval, 1.11 to 1.33) higher hazards of death, respectively, compared with the lower categories in adjusted analyses. The associations of waist circumference with ESRD varied by baseline renal function (P for interaction=0.01) and were significant only among women without baseline eGFR-defined CKD (hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.03).

CONCLUSIONS

Central obesity was associated with an increased risk of ESRD in postmenopausal women, even among women with normal body mass index but not among women with reduced baseline kidney function, and an increased risk of death. Body mass index was associated with ESRD, and the association is likely mediated through hypertension and diabetes.

Authors+Show Affiliations

Departments of Epidemiology and noraf@unc.edu.Biostatistics, University of North Carolina, Chapel Hill, North Carolina;Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington;Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, Rhode Island;MedStar Health Research Institute, Hyattsville, Maryland; Center for Clinical and Translational Sciences and Department of Medicine, Georgetown-Howard Universities, Washington, DC;Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; and.MedStar Health Research Institute, Hyattsville, Maryland; Center for Clinical and Translational Sciences and Department of Medicine, Georgetown-Howard Universities, Washington, DC;Departments of Epidemiology and.Section of Nephrology, Baylor College of Medicine, Houston, Texas.Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, Rhode Island;Departments of Epidemiology and.Biostatistics, University of North Carolina, Chapel Hill, North Carolina;

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25452225

Citation

Franceschini, Nora, et al. "Adiposity Patterns and the Risk for ESRD in Postmenopausal Women." Clinical Journal of the American Society of Nephrology : CJASN, vol. 10, no. 2, 2015, pp. 241-50.
Franceschini N, Gouskova NA, Reiner AP, et al. Adiposity patterns and the risk for ESRD in postmenopausal women. Clin J Am Soc Nephrol. 2015;10(2):241-50.
Franceschini, N., Gouskova, N. A., Reiner, A. P., Bostom, A., Howard, B. V., Pettinger, M., Umans, J. G., Brookhart, M. A., Winkelmayer, W. C., Eaton, C. B., Heiss, G., & Fine, J. P. (2015). Adiposity patterns and the risk for ESRD in postmenopausal women. Clinical Journal of the American Society of Nephrology : CJASN, 10(2), 241-50. https://doi.org/10.2215/CJN.02860314
Franceschini N, et al. Adiposity Patterns and the Risk for ESRD in Postmenopausal Women. Clin J Am Soc Nephrol. 2015 Feb 6;10(2):241-50. PubMed PMID: 25452225.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adiposity patterns and the risk for ESRD in postmenopausal women. AU - Franceschini,Nora, AU - Gouskova,Natalia A, AU - Reiner,Alex P, AU - Bostom,Andrew, AU - Howard,Barbara V, AU - Pettinger,Mary, AU - Umans,Jason G, AU - Brookhart,M Alan, AU - Winkelmayer,Wolfgang C, AU - Eaton,Charles B, AU - Heiss,Gerardo, AU - Fine,Jason P, Y1 - 2014/12/01/ PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/10/31/medline KW - ESRD KW - chronic renal failure KW - clinical epidemiology KW - epidemiology and outcomes KW - risk factors SP - 241 EP - 50 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 10 IS - 2 N2 - BACKGROUND AND OBJECTIVES: Body mass index and waist circumference associate with adverse health outcomes, including CKD. Studies of the association of body mass index and ESRD have been inconsistent; these adiposity measures have not been previously assessed together for ESRD risk or among postmenopausal women. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: This was prospective cohort study of 20,117 postmenopausal women enrolled in the multiethnic cohort of the Women's Health Initiative. Body mass index and waist circumference were obtained at baseline, incident ESRD was obtained from the US Renal Data System, and all-cause death was obtained from surveillance data. A competing-risk framework was used to account for the effect of mortality before ESRD while adjusting for significant predictors and baseline kidney function. Associations of adiposity with mortality were also studied. RESULTS: Events included 212 patients with incident ESRD and 3104 deaths for a mean follow-up of 11.6 years. Increased waist circumference and body mass index were associated with 2.59- (95% confidence interval, 1.89 to 3.53) and 1.97-fold (95% confidence interval, 1.30 to 2.98) higher hazards of ESRD as well as 1.42- (95% confidence interval, 1.32 to 1.53) and 1.21-fold (95% confidence interval, 1.11 to 1.33) higher hazards of death, respectively, compared with the lower categories in adjusted analyses. The associations of waist circumference with ESRD varied by baseline renal function (P for interaction=0.01) and were significant only among women without baseline eGFR-defined CKD (hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.03). CONCLUSIONS: Central obesity was associated with an increased risk of ESRD in postmenopausal women, even among women with normal body mass index but not among women with reduced baseline kidney function, and an increased risk of death. Body mass index was associated with ESRD, and the association is likely mediated through hypertension and diabetes. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/25452225/Adiposity_patterns_and_the_risk_for_ESRD_in_postmenopausal_women_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=25452225 DB - PRIME DP - Unbound Medicine ER -