Relationship between body mass index and proteinuria in hypertensive nephrosclerosis: Results from the African American study of kidney disease and hypertension (AASK) cohort

Robert D. Toto, Tom Greene, Lee A. Hebert, Leena Hiremath, Janice P. Lea, Julia B. Lewis, Velvie Pogue, Mohammed Sika, Xuelei Wang

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28 Scopus citations

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 proteincreatinine 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/m2. 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 proteincreatinine 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/m2 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.

Original languageEnglish (US)
Pages (from-to)896-906
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume56
Issue number5
DOIs
Publication statusPublished - Nov 2010

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Keywords

  • body mass index
  • chronic kidney disease
  • hypertension
  • Obesity
  • proteinuria

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

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