title: Body mass index and risk of ESRD in China.
abstract: BACKGROUND
  The relationship between body mass index (BMI) and risk of end-stage renal disease (ESRD) in Asians has not been well established.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  143,802 men and women 40 years and older in China.
  
  
  METHODS
  Body weight, height, and covariables were obtained at a baseline examination in 1991 by following a standardized protocol. BMI was calculated as weight in kilograms divided by the square of height in meters.
  
  
  RESULTS
  Time to onset of ESRD, ascertained in 1999 to 2000 from medical records, death certificates, and interviews with participants or their proxies.
  
  
  RESULTS
  During 1,112,667 person-years of follow-up, 350 participants initiated renal replacement therapy or died of renal failure. After adjustment for age, sex, geographic region (north versus south China), urbanization (urban versus rural residence), education, physical activity, cigarette smoking, and alcohol consumption, a J-shaped association between BMI and all-cause ESRD was observed. Compared with those with normal body weight (BMI, 18.5 to 24.9 kg/m(2)), multivariate-adjusted relative risks for all-cause ESRD for underweight (BMI < 18.5 kg/m(2)), overweight (BMI, 25.0 to 29.9 kg/m(2)), and obese subjects (BMI >or= 30 kg/m(2)) were 1.39 (95% confidence interval [CI], 1.02 to 1.91), 1.21 (95% CI, 0.92 to 1.59), and 2.14 (95% CI, 1.39 to 3.29), respectively. The J-shaped association existed even after additional adjustment for systolic blood pressure and history of diabetes and cardiovascular disease.
  
  
  CONCLUSIONS
  Although patients with ESRD at baseline were excluded, information for chronic kidney disease at the baseline examination was not available.
  
  
  CONCLUSIONS
  Strategies aimed at preventing the development of ESRD should incorporate measures to maintain a normal body weight.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. kristi.reynolds@kp.org
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Gu
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Xigui
authors.initials: X
authors.lastname: Wu
authors.forename: C Lillian
authors.initials: CL
authors.lastname: Yau
authors.forename: Xiufang
authors.initials: X
authors.lastname: Duan
authors.forename: Chung-Shiuan
authors.initials: CS
authors.lastname: Chen
authors.forename: L Lee
authors.initials: LL
authors.lastname: Hamm
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology