TY  - BOOK
AU  - Howard, Barbara V
AU  - Umans, Jason G
TI  - Adiposity patterns and the risk for ESRD in postmenopausal women
SN  - 1555-9041
KW  - *Adiposity
KW  - *African Americans
KW  - *European Continental Ancestry Group
KW  - *Hispanic Americans
KW  - *Kidney Failure, Chronic/eh [Ethnology]
KW  - *Obesity, Abdominal/eh [Ethnology]
KW  - *Postmenopause
KW  - Aged
KW  - Body Mass Index
KW  - Female
KW  - Humans
KW  - Incidence
KW  - Kidney Failure, Chronic/di [Diagnosis]
KW  - Kidney Failure, Chronic/mo [Mortality]
KW  - Kidney Failure, Chronic/pp [Physiopathology]
KW  - Kidney/pp [Physiopathology]
KW  - Middle Aged
KW  - Obesity, Abdominal/di [Diagnosis]
KW  - Obesity, Abdominal/mo [Mortality]
KW  - Obesity, Abdominal/pp [Physiopathology]
KW  - Proportional Hazards Models
KW  - Prospective Studies
KW  - Risk Factors
KW  - Time Factors
KW  - United States/ep [Epidemiology]
KW  - Waist Circumference
KW  - MedStar Health Research Institute
KW  - Comparative Study
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
N2  - BACKGROUND AND OBJECTIVES: Body mass index and waist circumference associate with adverse health outcomes, including CKD. Studies of the association of body mass index and ESRD have been inconsistent; these adiposity measures have not been previously assessed together for ESRD risk or among postmenopausal women; CONCLUSIONS: Central obesity was associated with an increased risk of ESRD in postmenopausal women, even among women with normal body mass index but not among women with reduced baseline kidney function, and an increased risk of death. Body mass index was associated with ESRD, and the association is likely mediated through hypertension and diabetes.Copyright � 2015 by the American Society of Nephrology; DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: This was prospective cohort study of 20,117 postmenopausal women enrolled in the multiethnic cohort of the Women's Health Initiative. Body mass index and waist circumference were obtained at baseline, incident ESRD was obtained from the US Renal Data System, and all-cause death was obtained from surveillance data. A competing-risk framework was used to account for the effect of mortality before ESRD while adjusting for significant predictors and baseline kidney function. Associations of adiposity with mortality were also studied; RESULTS: Events included 212 patients with incident ESRD and 3104 deaths for a mean follow-up of 11.6 years. Increased waist circumference and body mass index were associated with 2.59- (95% confidence interval, 1.89 to 3.53) and 1.97-fold (95% confidence interval, 1.30 to 2.98) higher hazards of ESRD as well as 1.42- (95% confidence interval, 1.32 to 1.53) and 1.21-fold (95% confidence interval, 1.11 to 1.33) higher hazards of death, respectively, compared with the lower categories in adjusted analyses. The associations of waist circumference with ESRD varied by baseline renal function (P for interaction=0.01) and were significant only among women without baseline eGFR-defined CKD (hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.03)
UR  - http://dx.doi.org/10.2215/CJN.02860314
ER  -