ArticleJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation2022
Cohort Study and Bias Analysis of the Obesity Paradox Across Stages of Chronic Kidney Disease.
Article in Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- The Role of Bariatric Surgery in Kidney Disease: Evidence, Controversies, and Future Needs.Obesity surgery · 2026Review
- Association of Body Roundness Index with all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3: a cohort study.American heart journal plus : cardiology research and practice · 2026Article
- Prognostic Value of Vascular Calcification in Long-Term Outcomes in Obese and Non-Obese Patients with Chronic Kidney Disease.Journal of cardiovascular development and disease · 2025Article
- The impact of BMI on disease activity and growth outcomes in juvenile idiopathic arthritis.European journal of pediatrics · 2025Article
- Risk prediction for cardiovascular events and all-cause mortality in maintenance hemodialysis patients.Frontiers in medicine · 2025Article
- Associations between the triglyceride-glucose index and the risk of heart failure in patients undergoing maintenance hemodialysis: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- The age-related obesity paradigm: results from two large prospective cohort studies.Journal of cachexia, sarcopenia and muscle · 2024Article
- Lipid parameters, adipose tissue distribution and prognosis prediction in chronic kidney Disease patients.Lipids in health and disease · 2024Article
- Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Article
- Metabolically healthy obesity is associated with higher risk of both hyperfiltration and mildly reduced estimated glomerular filtration rate: the role of serum uric acid in a cross-sectional study.Journal of translational medicine · 2023Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveIn advanced chronic kidney disease (CKD), patients with obesity often have better outcomes than patients without obesity, often called the 'obesity paradox'. Yet, in CKD, the prevalence of inflammation increases as CKD progresses. Although a potential confounder, inflammation may be left unaccounted in obesity-mortality studies. We examined the associations of body mass index (BMI) with all-cause and cause-specific mortality across CKD stages, with consideration for uncontrolled confounding due to unmeasured inflammation.
methodsWe investigated 2,703,512 patients with BMI data between 2004 and 2006. We used Cox models to examine the associations of BMI with all-cause, cardiovascular, and cancer mortality, (ref: BMI 25-<30 kg/m
resultsThe cohort included 5% females and 14% African Americans. In adjusted analyses, the associations of the BMI with all-cause and cardiovascular mortality showed a reverse J-shape, where a higher BMI (>40 kg/m
conclusionWe observed the presence of the obesity paradox in this study. This association was consistent in advanced CKD and in our bias analysis, suggesting that inflammation may not fully explain the observed BMI-mortality associations including in patients with CKD.
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