Temporal relation between body mass index and renal function in individuals with hypertension and excess body weight.
OBJECTIVE
Recent evidence has suggested obesity as an independent risk factor for chronic kidney disease. However, the temporal relation between body mass index (BMI) and early renal dysfunction is unknown. This study aimed at evaluating whether longitudinal variations in BMI would reflect on changes in estimated glomerular filtration rate (GFR) in hypertensive individuals with excess body weight.


METHODS
This was a cross-sectional, longitudinal study.


RESULTS
Of the 218 participants who attended the first examination, 150 were available for paired final analyses. At the end of follow-up, GFR decreased by 1.024 mL/min for each 1-kg/m(2) increment in BMI (P<0.03). When BMI was analyzed in quartiles, a positive graded relation with GFR changes was observed in quartiles 1 and 2 (individuals who maintained or lost weight), and a negative relation in quartiles 3 and 4 (individuals who gained weight, P=0.05). A significant difference was observed between the smallest and highest BMI quartiles (P=0.01). At the end of follow-up, the 76 participants (51%) who gained weight (+4.6+/-0.4 kg) showed a reduction in GFR (-2.99+/-1.99 mL/min) of borderline significance (P=0.06) and a significant increase in fasting plasma glucose and triacylglycerol levels. Conversely, the 74 participants who maintained or lost weight showed no significant change in GFR and in fasting plasma glucose and triacylglycerol levels, although their blood pressure decreased significantly.


CONCLUSIONS
Our study showed a significant temporal association between changes in BMI and GFR in overweight and obese hypertensive patients.
Gonçalves Torres
Márcia Regina Simas
MR
Hypertension Clinic, Laboratory of Clinical and Experimental Pathophysiology, CLINEX, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Cardoso
Luciana Guerra
LG
de Abreu
Virginia Genelhu
VG
Sanjuliani
Antonio Felipe
AF
Francischetti
Emilio Antonio
EA
D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000150:complications*; D051437:Renal Insufficiency / Q000209:etiology*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D015430:Weight Gain / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology
D001786:Blood Glucose; D014280:Triglycerides