title: Association of conicity index and renal progression in pre-dialysis chronic kidney disease.
abstract: OBJECTIVE
  Abdominal fat deposition is represented by means of the conicity index (CI), an anthropometric estimate that models the relative accumulation of abdominal fat. We examined the influence of markers of cardiovascular disease in terms of inflammation and lipid profile and body fat distribution on the progression of renal disease in patients with stable chronic kidney disease (CKD) stages 3-5.
  
  
  METHODS
  We studied 104 pre-dialysis CKD patients (64 males, 62%; age 64.6 ± 14.7 years). Glomerular filtration rate (GFR) was estimated (44.62 ± 14.38 mL/min/1.73 m2) by modification of diet in renal disease formula. GFR values were estimated at baseline and at the end of the 12-month follow-up. Patients were stratified into three groups: group 1 had a loss of GFR ≥20%; group 2 had a loss of GFR 10-20%; and group 3 patients had stable renal functions or GFR change <10% at the end of 12 months. Body mass index (BMI), waist/hip ratio (WHR), and CI were subsequently computed. Renal resistive index (RRI) was measured using Doppler ultrasonography.
  
  
  RESULTS
  CI was strongly correlated with total cholesterol (r = 0.37, p < 0.01), low-density lipoprotein (LDL) (r = 0.53, p < 0.01), C-reactive protein (r = 0.21, p < 0.05), and serum potassium (r = 0.216, p < 0.02), whereas BMI and WHR were not associated with these parameters. The values of CI, serum cholesterol, LDL, alkaline phosphatase, alanine aminotransferase, lactate dehydrogenase activity, the degree of proteinuria and microalbuminuria, and RRI were significantly lower in group 3. In linear regression model, LDL (r2 = 0.17, p = 0.02), uric acid (r2 = 0.19, p < 0.01), and RRI (r2 = 0.64, p < 0.01) were independently associated with CI for all groups.
  
  
  CONCLUSIONS
  CI is an independent predictor of systemic inflammation, cardiovascular risk, and GFR in patients during the pre-dialysis period.
authors.affiliation: Department of Nephrology, Baskent University, Ankara, Turkey.
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.forename: Sebnem
authors.initials: S
authors.lastname: Karakan
authors.forename: Nurhan Özdemir
authors.initials: NÖ
authors.lastname: Acar
mesh_terms: D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D050152:Intra-Abdominal Fat; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies