Files and links (1)
Published, Version of Record (VoR)CC BY-NC-ND V4.0, Open
Journal article
Obesity Weight Loss Phenotypes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study
Kidney international reports, v 8(7), pp 1352-1362
01 Jul 2023
PMID: 37441488
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Although people with chronic kidney disease (CKD) and obesity have important motivations to lose weight, weight loss is also associated with health risks. We examined whether patterns of change in systolic blood pressure (SBP), serum albumin level, and fat-free mass (FFM) can help to differentiate between healthy and high-risk weight loss in this population.
Methods: Using data from the Chronic Renal Insufficiency Cohort Study (CRIC), we estimated a joint multivariate latent class model with 6 classes to identify distinct trajectories of body mass index (BMI), albumin, and SBP among participants with obesity (BMI ≥30 kg/m2 at baseline), accounting for informative missingness from death. In a secondary analysis, we fit a 6-class model with BMI and FFM.
Results: Among 2831 participants (median baseline BMI 35.6, interquartile range [IQR] 32.4–40.0 kg/m2), median follow-up was 6.8 (IQR 4.8–12.9) years, median age was 61 (IQR 54–67) years, 53% were male, 50% were non-Hispanic Black, and 82% were trying to control or lose weight at baseline. Latent classes were associated with mortality risk (5-year cumulative incidence of mortality 6.8% and 1.5% in class 6 and 3, respectively). Class 6 had the highest mortality rate and was characterized by early, steep BMI loss, early serum albumin decline, and late SBP increase. In the secondary analysis, a class characterized by steep BMI and FFM loss was associated with the highest death risk.
Conclusions: Among adults with CKD and obesity, BMI loss with concomitant serum albumin or FFM loss was associated with a high risk of death.
Metrics
Details
- Title
- Obesity Weight Loss Phenotypes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study
- Creators
- CRIC Study InvestigatorsMeera N. Harhay - Drexel University, College of MedicineYuna Kim - Drexel University, Epidemiology and BiostatisticsBrandy-Joe Milliron - Drexel University, Health SciencesLucy F. Robinson - Drexel University, Epidemiology and BiostatisticsLawrence J. Appel - Johns Hopkins UniversityJing Chen - Tulane UniversityHarold I. Feldman - University of PennsylvaniaAlan S. Go - University of California, San FranciscoJames P Lash - University of Illinois ChicagoRobert G Nelson - Joslin Diabetes CenterMahboob RahmanPanduranga RaoVallabh O Shah - University of New MexicoRaymond R. Townsend - University of PennsylvaniaMark L Unruh - New Mexico VA Health Care System
- Publication Details
- Kidney international reports, v 8(7), pp 1352-1362
- Publisher
- Elsevier
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Epidemiology and Biostatistics; SOM Dean - Research Administration; Nutrition Sciences; Health Sciences
- Web of Science ID
- WOS:001031825500001
- Scopus ID
- 2-s2.0-85160029754
- Other Identifier
- 991020517072004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology