A BMI of more than 25 kg/m seems to be a protective factor for renal function deterioration in some patients.... 

 

Researchers conducted a 24-month, prospective, observational study on 105 individuals with type 2 diabetes and stage 3 or 4 CKD in order to examine the relationship between BMI and the progression of renal function deterioration. Patients were divided based on their BMI into 3 of the following groups: the normal group, which consisted of patients with a BMI between 18.5-22.9 kg/m, the overweight group, which consisted of patients with a BMI between 23-24.9 kg/m, and the obese group, which consisted of patients with a BMI ≥25 kg/m. A linear regression analysis with a stepwise method and a multivariate Cox regression analysis were performed on these patients. The primary end point was classified as either a 2-fold increase in serum creatinine levels from baseline values which were measured twice with a 1-month interval between measurements, a need for long-term dialysis, or death during the 24 months that the patients were being observed.

 

The results of the linear regression analysis indicated that the estimated glomerular filtration rate (GFR) was increased by 0.32 mL/min × 1.73 m with each 1 kg/m increase in BMI (95% CI, 0.01-0.62; p=0.04). The results of the multivariate Cox regression analysis indicated that, after adjusting for other factors, the primary outcome was achieved more quickly in the normal BMI group (HR=2.76, 95% CI, 1.27-6; p=0.01) when compared with the obese group.

 

Therefore, this study revealed that a BMI ≥25 kg/m is considered to be a protective factor for renal function deterioration in patients with type 2 diabetes who also have stage 3 or 4 CKD. Whether or not a high BMI will continue to produce beneficial effects in these patients for longer than a 24-month period is not certain.

 

Practice Pearls:

In patients with type 2 diabetes and stage 3 or 4 CKD, the GFR was shown to increase along with the increase in BMI.

The primary end point was classified as either a 2-fold increase in serum creatinine levels from baseline values which were measured twice with a 1-month interval between measurements, a need for long-term dialysis, or death during the 24 months that the patients were being observed.

A BMI ≥25 kg/m was a protective factor for renal function deterioration in these patients.

 

Huang WH, Chen CY, Lin JL, Lin-Tan DT, Hsu CW, Yen TH. High Body Mass Index Reduces Glomerular Filtration Rate Decline in Type II Diabetes Mellitus Patients With Stage 3 or 4 Chronic Kidney Disease. Medicine (Baltimore); 2014 Aug; 93(7):e41. PubMed PMID: 25101985.