title: Temporal relation between body mass index and renal function in individuals with hypertension and excess body weight.
abstract: 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.
authors.affiliation: Hypertension Clinic, Laboratory of Clinical and Experimental Pathophysiology, CLINEX, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Márcia Regina Simas
authors.initials: MR
authors.lastname: Gonçalves Torres
authors.forename: Luciana Guerra
authors.initials: LG
authors.lastname: Cardoso
authors.forename: Virginia Genelhu
authors.initials: VG
authors.lastname: de Abreu
authors.forename: Antonio Felipe
authors.initials: AF
authors.lastname: Sanjuliani
authors.forename: Emilio Antonio
authors.initials: EA
authors.lastname: Francischetti
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D014280:Triglycerides