CKD Progression Is Influenced by Adiposity

Adiposity is associated with an increased risk of heart disease and disease progression in patients with chronic kidney disease (CKD), according to the results of a recent study. 

Although it is well known that overweight and physical fitness affect cardiometabolic risk, their effects in patients with CKD are less well understood.

To assess this relationship, researchers conducted a prospective cohort study involving 419 participants with stage 3 to 5 CKD who were not receiving dialysis. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intrahepatic fat, and physical function with inflammation, insulin resistance, and adipokines were all assessed.

Overall, they found that higher VAT, SAT, and liver proton density fat fraction were all associated with total and high molecular weight adiponectin, higher levels of leptin and insulin resistance, lower HDL cholesterol and higher serum triglycerides. Slower time to complete a 400m walk test was associated with higher leptin, total adiponectin, and plasma IL-6 and TNFR-1.

“Various measures of adiposity are associated with cardiometabolic risk factors. Physical function was also associated with the cardiometabolic risk factors studied and does not modify the associations between fat measures and cardiometabolic risk factors. Longitudinal studies of the relationship between body fat and aerobic fitness with cardiovascular and kidney disease progression are warranted,” they concluded.

—Michael Potts

Reference:

Navaneethan SD, Kirwan JP, Remer EM, et al. Adiposity, physical function, and their associations with insulin resistance, inflammation, and adipokines in CKD. Published online August 13, 2020. AJKD. doi:10.1053/j.ajkd.2020.05.028