Obesity, Smoking, and Physical Inactivity as Risk Factors for CKD: Are Men More Vulnerable?

Leiden University, Leyden, South Holland, Netherlands
American Journal of Kidney Diseases (Impact Factor: 5.9). 03/2006; 47(3):396-405. DOI: 10.1053/j.ajkd.2005.11.027
Source: PubMed


The incidence of end-stage renal disease is especially high in men, and some studies indicated that smoking is a risk factor for men only. We investigated associations between obesity, smoking, and physical inactivity and chronic kidney disease (CKD) in the general population and whether risk for CKD was restricted to men.
This was a cross-sectional health survey of the entire adult population of Nord-Trondelag County, Norway, 1995 to 1997, with a 70.6% participation rate. Glomerular filtration rate (GFR) was estimated in all subjects 20 years and older from calibrated serum creatinine levels by using the simplified Modification of Diet in Renal Disease Study formula, and CKD cases are defined as those with a GFR less than 45 mL/min/1.73 m2 (< 0.75 mL/s).
A total of 30,485 men and 34,708 women were included, and prevalences of GFR less than 45 mL/min/1.73 m2 (< 0.75 mL/s) were 0.8% and 1.1%, respectively. Age- and sex-adjusted logistic regression analyses showed dose-response relations for body mass index, smoking history, and physical activity. Relative risks were 1.77 (95% confidence interval [CI], 1.47 to 2.14) for obesity (body mass index > or = 30 kg/m2), 1.52 (95% CI, 1.13 to 2.06) for smoking (> 25 pack-years), and 2.14 (95% CI, 1.39 to 3.30) for physical inactivity (no or some physical activity in leisure time). For subjects with all these risk factors, relative risk was 5.10 (95% CI, 2.36 to 11.01). These results remained significant after adjusting for other known risk factors. No biological interactions between sex and obesity, smoking, or physical activity were found.
Obesity, smoking, and physical inactivity were associated significantly with CKD. Men were not more susceptible to these risk factors than women.

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    • "The increasing prevalence of CKD requests us to find out more efficient markers for monitoring the prevalence of CKD. Several studies have suggested that obesity and the metabolic syndrome are independent predictors of CKD [17], [26]–[29]. Body mass index (BMI) was widely used as a marker of obesity. But fluid overload and body fat distribution should be considered. "
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    ABSTRACT: To examine the relationship between the HW phenotype and risk for CKD in a community population aged 40 years and older. A cross-sectional study was conducted in Zhuhai from June to October 2012. The participants were divided into three groups: Group 1, Waist circumference >90 cm in men or >85 cm in women and triglycerides ≥2 mmol/l; Group 3, Waist circumference ≤90 cm in men or ≤85 cm in women and triglycerides <2 mmol/l; Group 2, The remaining participants. The prevalence of the three subgroups and CKD were determined. The association between HW phenotype and CKD was then analyzed using SPSS (version 13.0). After adjusting for age and sex, Group 1 was associated with CKD (OR 3.08, 95% CI 2.01, 4.73, P<0.001), when compared with Group 3. Further adjustment for factors which were potential confounders and unlikely to be in the causal pathway between the HW phenotype and CKD, Group 1 was still significantly associated with CKD. The OR for CKD was 2.65 (95% CI 1.65, 4.26, P<0.001). When adjusted for diabetes and hypertension, the association of Group 1 and CKD was still significant (OR 2.09, 95% CI 1.26, 3.45, P = 0.004). Group 2 was associated with CKD (OR 1.81, 95% CI 1.29, 2.53, P = 0.001), when compared with Group 3. Further adjustment for factors which were potential confounders, Group 2 was still significantly associated with CKD. The OR for CKD was 1.75 (95% CI 1.22, 2.51, P = 0.002). When adjusted for diabetes and hypertension, the association between Group 2 and CKD still existed. The OR for CKD was 1.48 (95% CI 1.01, 2.16, P = 0.046). Our results showed that HW phenotype was associated with CKD in the population aged 40 years and older.
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    • "In the present study daily physical activity was positively correlated with creatinine clearance. Indeed, previous studies have shown that habitual physical activity was positively associated with renal function [31–33]. Why decrease in creatinine clearance was associated with decreased physical activity? "
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