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Obesity Weight Loss Phenotypes in Chronic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort Study (CRIC)
Letter/Communication   Open access   Peer reviewed

Obesity Weight Loss Phenotypes in Chronic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort Study (CRIC)

Meera Harhay, Yuna Kim, Brandy-Joe Milliron and Lucy Robinson
Kidney international reports, v 8(11), pp 2492-2493
Nov 2023
DOI: https://doi.org/10.1016/j.ekir.2023.09.027
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.ekir.2023.09.027View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

The Author Replies: We thank Dr. Rico-Fontalvo and colleagues for their interest in our study. They suggest that we further adjust our statistical model for baseline albuminuria, which is an important predictor of kidney disease progression and cardiovascular outcomes. Due to missingness of baseline albuminuria data in our study population (33%), we present results after adjustment for baseline urine protein-to-creatinine ratio (UPCR), given that urinary protein excretion is an independent predictor of kidney function trajectory1 and cardiovascular risk.2 To examine the association between the estimated latent classes from the 6-class model in the primary analysis and the risk of death after further adjustment for baseline UPCR (mg/g), we excluded 150 Chronic Renal Insufficiency Cohort participants (5.3%) with missing baseline UPCR information, leaving 2681 participants that were eligible to be included in the analysis. We fit a Cox model with the 6 estimated latent classes from our primary analysis as predictors, adjusting for baseline age, sex, race/ethnicity, baseline diabetes status, baseline estimated glomerular filtration rate, baseline body mass index, baseline systolic blood pressure, baseline serum albumin level, initiation of dialysis or transplantation, weight loss intention at baseline, and baseline standardized UPCR (i.e., per SD increase). Stratified by latent class, mean (SD) UPCR levels are shown in Table 1.Similar to findings in our original analysis, we observed that mortality was highest inclasses1,2,4,and6,andlowestinclasses3and 5 after adjustment for UPCR and other covariates. Relative to class 3, adjusted hazard ratios for weight loss phenotypes 1 and 6, which were associated with the highest mortality in our original analysis, were3.95(95% confidence interval 3.22–4.84) and 3.77 (95% confidence interval 2.86–4.97), respectively. Findings were also consistent when adjusting for baseline urine albumin-to-creatinine ratio instead of UPCR, after excluding those participants with missing albuminuria data.

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Web of Science research areas
Urology & Nephrology
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