title: Prevalence of renal insufficiency in individuals with hypertension and obesity/overweight: the FATH study.
abstract: Overweight and obesity are associated with increased cardiovascular risk. Some studies have demonstrated that they also can result in renal damage. The aim of this study was to assess the prevalence of renal insufficiency (RI), defined as a GFR <60 ml/min per 1.73 m2, in a cohort of 4585 patients who attended primary care with essential hypertension and a body mass index > or =25 kg/m2. The patients were classified as overweight and obese according to body mass index (25 to 29.9 and > or =30 kg/m2, respectively). Abdominal obesity was defined as a waist circumference > or =88 and 102 cm in women and men, respectively. Both groups had a high prevalence of metabolic syndrome (Adult Treatment Panel III). The prevalence of RI was high in both the overweight group (22.7%; 95% confidence interval [CI] 20.6 to 24.9) and in the obese group (22.8%; 95% CI 21.0 to 24.7). The presence of diabetes increased the risk for RI (odds ratio 1.83; 95% CI 1.55 to 2.16). The prevalence of RI was greater in patients with abdominal obesity (23 versus 17%; P < 0.001). In the presence of abdominal obesity, cardiovascular risk factors and components of the metabolic syndrome also were more prevalent. The higher risk for RI with abdominal obesity persisted even after adjustment for dyslipidemia, elevated blood glucose levels, and other variables that are associated with RI (adjusted odds ratio 1.40; 95% CI 0.84 to 2.33). It was concluded that patients who have hypertension and visceral obesity and attend primary care present a higher prevalence of metabolic syndrome and RI.
authors.affiliation: Nephrology Department, Hospital del SAS, Jeréz de la Frontera, Madrid, Spain (11407). pgomezf@senefro.org
authors.forename: Pablo
authors.initials: P
authors.lastname: Gomez
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Vivencio
authors.initials: V
authors.lastname: Barrios
authors.forename: Jorge
authors.initials: J
authors.lastname: Navarro
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Prieto
authors.forename: Olga
authors.initials: O
authors.lastname: Gonzalez
authors.forename: Lucía
authors.initials: L
authors.lastname: Guerrero
authors.forename: Miguel Angel Sanchez
authors.initials: MA
authors.lastname: Zamorano
authors.forename: Claudia
authors.initials: C
authors.lastname: Filozof
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology; D015995:Prevalence; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D049629:Waist-Hip Ratio