Files and links (1)
PDFOpen Access (License Unspecified), Open Access
Dissertation
Obesity and physical functioning in chronic kidney disease
Doctor of Public Health (Dr.P.H.), Drexel University
May 2010
DOI:
https://doi.org/10.17918/00008729
Abstract
Background. Chronic kidney disease (CKD), obesity and disability are important public health concerns. Specific guidelines for obesity management and physical functioning screening for CKD patients are lacking. We examined differences in adiposity, body mass index (BMI) and physical functioning between CKD patients and healthy controls. Methods. Baseline data from the Chronic Renal Insufficiency (CRIC) study in 514 CKD patients and 232 controls age 21-79 years. Fat mass index and fat free mass index (FMI, FFMI (kg/m2)) were computed from whole body dual-energy X-ray absorptiometry. BMI was measured as weight(kg)/height(m)2. Physical functioning was scored using the Short Physical Performance Battery (SPPB). Using general linear models to control for age, gender and race, we compared FMI, BMI and FFMI between CKD patients and controls. Additional models tested group differences in FMI within BMI categories. Ordinal logistic regression models determined odds ratios (OR) of patients with CKD having low or medium (as opposed to high) SPPB scores. Results. Moderate CKD patients had 26% greater FMI, 12% higher BMI and 37% more FFMI than controls. Severe CKD patients had 17% more FMI, 7% higher BMI and 5% less FFMI compared to controls. Within normal, overweight and severe obese BMI categories, FMI did not differ between CKD patients and controls. However, in obese BMI category, FMI was significantly lower in severe CKD patients compared to controls (B=-0.17, p=0.004, 95%Cl (-0.28 to -0.06). CKD patients were more likely to have poor physical functioning compared to controls. However, the OR was modified by age and BMI category. With increasing age, and with increasing BMI, the effect of CKD on SPPB scores diminished. Therefore, younger patients, and patients with lower BMI had greater odds of poor physical functioning. Conclusions. CKD patients are more likely to have higher adiposity, be more obese and have poor physical functioning than controls. BMI is a reliable tool for monitoring obesity in patients with CKD. The effect of CKD on physical functioning is greater in younger patients and in less obese patients. Implications. Clinical, public health, and policy guidelines for obesity management and screening for declining physical functioning in CKD patients are needed.
Metrics
11 File views/ downloads
10 Record Views
Details
- Title
- Obesity and physical functioning in chronic kidney disease
- Creators
- Lucy Wachera Kibe
- Contributors
- Randall Sell (Advisor) - Drexel University, Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Public Health (Dr.P.H.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- various pagings
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- School of Public Health (2002-2015); Drexel University
- Other Identifier
- 991021888852904721