Body Mass Index and Risk for End-Stage Renal Disease
Abstract
BACKGROUND: Although interest in the relationship between obesity and kidney disease is increasing, few epidemiologic studies have examined whether excess weight is an independent risk factor for end-stage renal disease (ESRD). OBJECTIVE: To determine the association between increased body mass index (BMI) and risk for ESRD. DESIGN: Historical (nonconcurrent) cohort study. SETTING: A large integrated health care delivery system in northern California. PARTICIPANTS: 320,252 adult members of Kaiser Permanente who volunteered for screening health checkups between 1964 and 1985 and who had height and weight measured. MEASUREMENTS: The authors ascertained ESRD cases by matching data with the U.S. Renal Data System registry through 2000. RESULTS: A total of 1471 cases of ESRD occurred during 8,347,955 person-years of follow-up. Higher BMI was a risk factor for ESRD in multivariable models that adjusted for age, sex, race, education level, smoking status, history of myocardial infarction, serum cholesterol level, urinalysis proteinuria, urinalysis hematuria, and serum creatinine level. Compared with persons who had normal weight (BMI, 18.5 to 24.9 kg/m2), the adjusted relative risk for ESRD was 1.87 (95% CI, 1.64 to 2.14) for those who were overweight (BMI, 25.0 to 29.9 kg/m2), 3.57 (CI, 3.05 to 4.18) for those with class I obesity (BMI, 30.0 to 34.9 kg/m2), 6.12 (CI, 4.97 to 7.54) for those with class II obesity (BMI, 35.0 to 39.9 kg/m2), and 7.07 (CI, 5.37 to 9.31) for those with extreme obesity (BMI > or = 40 kg/m2). Higher baseline BMI remained an independent predictor for ESRD after additional adjustments for baseline blood pressure level and presence or absence of diabetes mellitus. LIMITATIONS: Primary analyses were based on single measurements of exposures. CONCLUSIONS: High BMI is a common, strong, and potentially modifiable risk factor for ESRD.
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In a retrospective analysis of 320,252 adults followed for 15-35 years, the rate of ESRD increased stepwise as BMI increased and this relationship remained after adjustment for BP, diabetes, smoking, age, and several other variables.
“In a retrospective analysis of 320,252 adults followed for 15–35 years, the rate of ESRD increased stepwise as BMI increased and this relationship remained after adjustment for BP, diabetes, smoking, age, and several other variables141.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [141]
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- Authors
- Hsu, C.-Y., McCulloch, C. E., Iribarren, C., Darbinian, J., & Go, A. S.
- Affiliations
- Kaiser Permanente (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2006-01-03
- Volume
- 144
- Issue
- 1
- Pages
- 21-28
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2080760372
- Cited by
- 1,390
- References
- 47
- Citations by year
- 2026: 24 · 2025: 56 · 2024: 73 · 2023: 53 · 2022: 53 · 2021: 84 · 2020: 64 · 2019: 51 · 2018: 59 · 2017: 80 · 2016: 82 · 2015: 70 · 2014: 72 · 2013: 69 · 2012: 88
- FWCI
- 61.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCLA - Biblioteca de Ciencias de la Salud (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL71074, R01HL071074)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 61520, K23DK061520)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- body mass index, obesity, end-stage renal disease, kidney disease, overweight, risk factors, proteinuria, diabetes mellitus, blood pressure, Kaiser Permanente
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic, Male, Middle Aged, Obesity, Retrospective Studies, Risk Factors, Body Mass Index, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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