title: Assessment of obesity in chronic kidney disease:  what is the best measure?
abstract: OBJECTIVE
  Obesity is a major driver of the current epidemic of chronic kidney disease (CKD), but metrics of obesity in the CKD population have been studied sparsely. This review updates knowledge on this issue.
  
  
  RESULTS
  Measures of abdominal obesity, waist circumference and waist-to-hip ratio (WHR), are better predictors than BMI of the high risk of mortality in predialysis and dialysis patients and waist circumference reliably reflects visceral fat in CKD patients. Skinfold thickness and WHR are superior to BMI for the classification of obesity in CKD patients. Multifrequency body impedance analysis (BIA) provides valid estimates of fat mass in hemodialysis patients.
  
  
  CONCLUSIONS
  Skinfold thickness,WHR and multifrequency BIA are superior to BMI for measuring body fat in CKD patients and measures of abdominal obesity are stronger predictors of adverse clinical outcomes than the BMI. These metrics should be preferentially applied for the assessment of obesity in CKD, but it remains unproven that these techniques offer real advantages over the BMI in clinical practice in CKD patients.
authors.affiliation: Unità Operativa di Nefrologia, Dialisi e Trapianto Renale Ospedali Riunitiand IBIM-CNR, Epidemiologia Clinica e Fisiopatologia delle Malattie Renali e dell'Ipertensione Arteriosa, Reggio Calabria, Italy. carmine.zoccali@tin.it
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.forename: Claudia
authors.initials: C
authors.lastname: Torino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepiand
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
mesh_terms: D050154:Adiposity; D000818:Animals; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D017097:Electric Impedance; D006801:Humans; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000628:therapy; D012885:Skinfold Thickness; D055105:Waist Circumference; D049629:Waist-Hip Ratio