Differential prognostic utility of adiposity measures in chronic kidney disease
Creators: name: Cejka, Vladimir
name: Störk, Stefan
name: Nadal, Jennifer
name: Schmid, Matthias
name: Sommerer, Claudia
name: Sitter, Thomas
name: Meiselbach, Heike
name: Busch, Martin
name: Schneider, Markus P.
name: Saritas, Turgay
name: Schultheiss, Ulla T.
name: Kotsis, Fruzsina
name: Wanner, Christoph
name: Eckardt, Kai-Uwe
name: Krane, Vera
name: Eckardt, Kai-Uwe
name: Meiselbach, Heike
name: Schneider, Markus P.
name: Schiffer, Mario
name: Prokosch, Hans-Ulrich
name: Bärthlein, Barbara
name: Beck, Andreas
name: Reis, André
name: Ekici, Arif B.
name: Becker, Susanne
name: Becker-Grosspitsch, Dinah
name: Alberth-Schmidt, Ulrike
name: Hausknecht, Birgit
name: Weigel, Anke
name: Walz, Gerd
name: Köttgen, Anna
name: Schultheiß, Ulla T.
name: Kotsis, Fruzsina
name: Meder, Simone
name: Mitsch, Erna
name: Reinhard, Ursula
name: Floege, Jürgen
name: Saritas, Turgay
name: Schaeffner, Elke
name: Baid-Agrawal, Seema
name: Theisen, Kerstin
name: Haller, Hermann
name: Zeier, Martin
name: Sommerer, Claudia
name: Theilinger, Johanna
name: Wolf, Gunter
name: Busch, Martin
name: Paul, Rainer
name: Sitter, Thomas
name: Wanner, Christoph
name: Krane, Vera
name: Börner-Klein, Antje
name: Bauer, Britta
name: Kronenberg, Florian
name: Raschenberger, Julia
name: Kollerits, Barbara
name: Forer, Lukas
name: Schönherr, Sebastian
name: Weissensteiner, Hansi
name: Oefner, Peter J.
name: Gronwald, Wolfram
name: Schmid, Matthias
name: Nadal, Jennifer
Publisher: name: Universität Regensburg
Year: 2023
Subjects: subject: 610 Medizin

description: Objective Adipose tissue contributes to adverse outcomes in chronic kidney disease (CKD), but there is uncertainty regarding the prognostic relevance of different adiposity measures. We analyzed the associations of neck circumference (NC), waist circumference (WC), and body mass index (BMI) with clinical outcomes in patients with mild to severe CKD. Methods The German Chronic Kidney Disease (GCKD) study is a prospective cohort study, which enrolled Caucasian adults with mild to severe CKD, defined as estimated glomerular filtration rate (eGFR): 30–60 mL/min/1.73 m2, or &gt;60 mL/min/1.73 m2 in the presence of overt proteinuria. Associations of NC, WC and BMI with all-cause death, major cardiovascular events (MACE: a composite of non-fatal stroke, non-fatal myocardial infarction, peripheral artery disease intervention, and cardiovascular death), kidney failure (a composite of dialysis or transplantation) were analyzed using multivariable Cox proportional hazards regression models adjusted for confounders and the Akaike information criteria (AIC) were calculated. Models included sex interactions with adiposity measures. Results A total of 4537 participants (59% male) were included in the analysis. During a 6.5-year follow-up, 339 participants died, 510 experienced MACE, and 341 developed kidney failure. In fully adjusted models, NC was associated with all-cause death in women (HR 1.080 per cm; 95% CI 1.009–1.155), but not in men. Irrespective of sex, WC was associated with all-cause death (HR 1.014 per cm; 95% CI 1.005–1.038). NC and WC showed no association with MACE or kidney failure. BMI was not associated with any of the analyzed outcomes. Models of all-cause death including WC offered the best (lowest) AIC. Conclusion In Caucasian patients with mild to severe CKD, higher NC (in women) and WC were significantly associated with increased risk of death from any cause, but BMI was not.