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Observational Study
. 2024 Jan 22;39(3):e12.
doi: 10.3346/jkms.2024.39.e12.

The Impact of Obesity on Kidney Disease: Observational Cohort Study Analyzing 14,492 Kidney Biopsy Cases

Tae-Bum Kim  1 , Shin Young Ahn  2 , Jieun Oh  3 , Eun Hui Bae  4 , Ho Jun Chin  5 , Myung-Gyu Kim  6 , Sang Kyung Jo  6 , Won Yong Cho  6 , Se Won Oh  7
Affiliations
Observational Study

The Impact of Obesity on Kidney Disease: Observational Cohort Study Analyzing 14,492 Kidney Biopsy Cases

Tae-Bum Kim et al. J Korean Med Sci. .

Abstract

Background: The obesity epidemic is associated with the emergence of new kidney diseases including obesity-related glomerulopathy (ORG) and metabolic syndrome-associated disorders. However, the effects of obesity on prevalence and outcome of biopsy-proven kidney disease are not well known.

Methods: We analyzed 14,492 kidney biopsies in 18 hospitals from 1979 to 2018 in Korea. Obesity was defined as a body mass index value of ≥ 30 kg/m².

Results: The most common disease was IgA nephropathy (IgAN) in both obese and non-obese participants (33.7% vs. 38.9%). Obesity was associated with a higher risk of focal segmental glomerulosclerosis (FSGS) and hypertensive nephropathy (HT-N) (odds ratio [OR], 1.72, 95% confidence interval [CI], 1.37-2.17; OR, 1.96, 95% CI, 1.21-3.19) and a lower risk of IgAN (OR, 0.74, 95% CI, 0.62-0.88). During the median follow up of 93.1 ± 88.7 months, obesity increased the risk of end-stage kidney disease (ESKD) in patients with IgAN (relative risk [RR], 1.49, 95% CI, 1.01-2.20) and lupus nephritis (LN) (RR, 3.43, 95% CI, 1.36-8.67). Of 947 obese individuals, ORG was detected in 298 (31.5%), and 230 participants had other kidney diseases, most commonly, IgAN (40.9%) followed by diabetic nephropathy (15.2%). Participants with ORG, when combined with other renal diseases, showed higher risks for developing ESKD compared to those with ORG alone (RR, 2.48, 95% CI, 1.09-5.64).

Conclusion: Obesity is associated with an increased risk of FSGS and HT-N, and also increase the ESKD risk in IgAN and LN patients. ORG in obese participants may have favorable renal outcomes if it occurs alone without any other renal disease.

Keywords: Chronic Kidney Disease; End Stage Kidney Disease; Glomerular Disease; Kidney Biopsy; Obesity; Obesity-Related Glomerulopathy.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Selection of the study population.
BMI = body mass index.
Fig. 2
Fig. 2. Prevalence of obesity in participants undergoing kidney biopsies from 1979–1988 to 2009–2018.
Fig. 3
Fig. 3. Prevalence of kidney disease confirmed by pathology according to obesity.
BMI = body mass index, IgAN = IgA nephropathy, FSGS = focal segmental glomerulosclerosis, MCD = minimal change disease, MN = membranous nephropathy, DMN = diabetic nephropathy, LN = lupus nephritis, HT-N = hypertensive nephropathy, MPGN = membranoproliferative glomerulonephritis, C3G = complement 3 glomerulopathy, ATN = acute tubular necrosis.
See this image and copyright information in PMC

References

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