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  • Title: Relationship between body mass index and proteinuria in hypertensive nephrosclerosis: results from the African American Study of Kidney Disease and Hypertension (AASK) cohort.
    Author: Toto RD, Greene T, Hebert LA, Hiremath L, Lea JP, Lewis JB, Pogue V, Sika M, Wang X, AASK Collaborative Research Group.
    Journal: Am J Kidney Dis; 2010 Nov; 56(5):896-906. PubMed ID: 20801567.
    Abstract:
    BACKGROUND: Few studies have examined the association between obesity and markers of kidney injury in a chronic kidney disease population. We hypothesized that obesity is independently associated with proteinuria, a marker of chronic kidney disease progression. STUDY DESIGN: Observational cross-sectional analysis. SETTING & PARTICIPANTS: Post hoc analysis of baseline data for 652 participants in the African American Study of Kidney Disease (AASK). PREDICTORS: Obesity, determined using body mass index (BMI). MEASUREMENTS & OUTCOMES: Urine total protein-creatinine ratio and albumin-creatinine ratio measured in 24-hour urine collections. RESULTS: AASK participants had a mean age of 60.2 ± 10.2 years and serum creatinine level of 2.3 ± 1.5 mg/dL; 61.3% were men. Mean BMI was 31.4 ± 7.0 kg/m(2). Approximately 70% of participants had a daily urine total protein excretion rate <300 mg/d. In linear regression analyses adjusted for sex, each 2-kg/m(2) increase in BMI was associated with a 6.7% (95% CI, 3.2-10.4) and 9.4% (95% CI, 4.9-14.1) increase in urine total protein-creatinine and urine albumin-creatinine ratios, respectively. In multivariable models adjusting for age, sex, systolic blood pressure, serum glucose level, uric acid level, and creatinine level, each 2-kg/m(2) increase in BMI was associated with a 3.5% (95% CI, 0.4-6.7) and 5.6% (95% CI, 1.5-9.9) increase in proteinuria and albuminuria, respectively. The interaction between older age and BMI was statistically significant, indicating that this relationship was driven by younger AASK participants. LIMITATIONS: May not generalize to other populations; cross-sectional analysis precludes statements regarding causality. CONCLUSIONS: BMI is associated independently with urine total protein and albumin excretion in African Americans with hypertensive nephrosclerosis, particularly in younger patients.
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