Fluctuating BMI linked to poor prognosis in Chronic Kidney Disease: Study

South Korean researchers found that people who had chronic kidney disease (CKD) with recent fluctuating body mass index showed higher risk of cardiovascular disease or death, without the influence of their current body mass index (BMI). They published the findings online in the Journal of American Society of Nephrology, August 2021 Issue.

In this retrospective study the authors looked into the relationship of BMI variability with risks of all-cause mortality, acute myocardial infarction, stroke, and the need for Kidney Replacement Therapy (KRT). 84,636 individuals with predialysis CKD in South Korea were included.

Variability in BMI or metabolic parameters until baseline measurement was the study exposure, which was computed as variance independent of the mean and divided into quartiles (with Q4 the highest quartile and Q1 the lowest).

o The study brought out that higher BMI variability was linked to increased risk of all-cause mortality, KRT, myocardial infarction, and stroke.

o Over the span of exposure assessment period the subgroups provided similar results regardless of the positive or negative trend in BMI.

o It was also noticed that variations in specific metabolic syndrome components such as waist circumference, fasting blood glucose, blood pressure, and lipid profile were also linked to tamper the prognosis of patients with predialysis CKD's.

o This study showed that the prognosis was worse in patients having a larger number of metabolic syndrome components with significant variability.

In conclusion, this the lead Dr. Sehoon Park pointed out that elevated variability in BMI or other metabolic parameters was associated with higher risks of adverse outcomes, regardless of the baseline metabolic status. Since these findings interact with potential prognostic significance it can greatly help clinicians to carefully assess baseline BMI, the metabolic status in patients with CKD and also the fluctuating status of metabolic parameters in such patients.

Reference

Park, S., Cho, S., Lee, S., Kim, Y., Park, S., Kim, Y. C., Han, S. S., Lee, H., Lee, J. P., Joo, K. W., Lim, C. S., Kim, Y. S., Han, K., & Kim, D. K. (2021). The Prognostic Significance of Body Mass Index and Metabolic Parameter Variabilities in Predialysis CKD: A Nationwide Observational Cohort Study. Journal of the American Society of Nephrology, ASN.2020121694. https://doi.org/10.1681/asn.2020121694