Overweight, obese hypertensives risk kidney disease

NEW YORK (Reuters Health) – Chronic kidney disease is much
more likely to develop in overweight and obese people with high
blood pressure (hypertension) than in those of ideal body
weight, according to the results of a large study.

In the past two decades, the prevalence of obesity in US
adults has doubled from 15 percent to more than 30 percent such
that two thirds of US adults are now overweight or obese.
Overweight and obesity are established risk factors for several
chronic ailments, including hypertension, diabetes, and heart
disease, but information on risk for chronic kidney disease in
overweight and obese individuals is currently limited.

The current study supports “an association between obesity
and risk of chronic kidney disease in this high-risk
population,” lead investigator Dr. Holly Kramer told Reuters
Health. “Obesity represents a constellation of risk factors
mediated by insulin resistance which we know increases
cardiovascular risk.”

Kramer of Loyola Medical Center, Maywood, Illinois and
colleagues reviewed data for almost 6000 hypertensive adults,
none of whom had chronic kidney disease at baseline.

After 5 years, the incidence of chronic kidney disease was
28 percent in those of ideal body mass, 31 percent in those who
were overweight and 34 percent in the obese, the researchers
report in the American Journal of Kidney Diseases.

After adjustment for factors including diabetes and blood
pressure, both being overweight and being obese were
significantly associated with the development of chronic kidney
disease.

Given the effect of obesity on heart disease, Kramer
concluded, “it shouldn’t be surprising that obesity also
increases the risk of chronic kidney disease. The propagating
epidemic of obesity in the US can only lead to increasing
incidence of CKD over the next decade.”

SOURCE: American Journal of Kidney Disease, October 2005.