Modeling the impact of obesity on the lifetime risk of chronic kidney disease in the United States using updated estimates of GFR progression from the CRIC study

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Yarnoff, Benjamin O. ; Hoerger, Thomas J. ; Shrestha, Sundar S. ; Simpson, Siobhan K. ; Burrows, Nilka R. ; Anderson, Amanda H. ; Xie, Dawei ; Chen, Hsiang-Yu ; Pavkov, Meda E.
• Corporate Authors:
  CRIC Study Investigators
• Description:
  Rationale & objective
  
  As the prevalence of obesity continues to rise in the United States, it is important to understand its impact on the lifetime risk of chronic kidney disease (CKD).
  
  Study design
  
  The CKD Health Policy Model was used to simulate the lifetime risk of CKD for those with and without obesity at baseline. Model structure was updated for glomerular filtration rate (GFR) decline to incorporate new longitudinal data from the Chronic Renal Insufficiency Cohort (CRIC) study.
  
  Setting and population
  
  The updated model was populated with a nationally representative cohort from National Health and Nutrition Examination Survey (NHANES).
  
  Outcomes
  
  Lifetime risk of CKD, highest stage and any stage.
  
  Model, perspective, & timeframe
  
  Simulation model following up individuals from current age through death or age 90 years.
  
  Results
  
  Lifetime risk of any CKD stage was 32.5% (95% CI 28.6%–36.3%) for persons with normal weight, 37.6% (95% CI 33.5%–41.7%) for persons who were overweight, and 41.0% (95% CI 36.7%–45.3%) for persons with obesity at baseline. The difference between persons with normal weight and persons with obesity at baseline was statistically significant (p<0.01). Lifetime risk of CKD stages 4 and 5 was higher for persons with obesity at baseline (Stage 4: 2.1%, 95% CI 0.9%–3.3%; stage 5: 0.6%, 95% CI 0.0%–1.1%), but the differences were not statistically significant (stage 4: p = 0.08; stage 5: p = 0.23).
  
  Limitations
  
  Due to limited data, our simulation model estimates are based on assumptions about the causal pathways from obesity to CKD, diabetes, and hypertension.
  
  Conclusions
  
  The results of this study indicate that obesity may have a large impact on the lifetime risk of CKD. This is important information for policymakers seeking to set priorities and targets for CKD prevention and treatment.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Age Factors Body Mass Index Computer Simulation Disease Progression Female Glomerular Filtration Rate Humans Longitudinal Studies Male Middle Aged Models, Biological Nutrition Surveys Obesity Renal Insufficiency, Chronic Risk Factors

  More +
• Source:
  PLoS One. 13(10).
• Pubmed ID:
  30339684
• Pubmed Central ID:
  PMC6195263
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  13
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7420b42f5e7d573058c76f47afb457e0b701bc506ea7686688cf5a178dd8b4e6
• Download URL:
  https://stacks.cdc.gov/view/cdc/60787/cdc_60787_DS1.pdf
• File Type:
  [PDF - 835.66 KB ]