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Obesity and CKD: How to Assess the Risk?
Eberhard Ritz
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 1-6)
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Waist-to-Hip Ratio, Body Mass Index, and Subsequent Kidney Disease and Death
, 30 May 2008
Essam F. Elsayed, Mark J. Sarnak, Hocine Tighiouart, John L. Griffith, Tobias Kurth, Deeb N. Salem, Andrew S. Levey, Daniel E. Weiner
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 29-38)
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Overweight, Obesity, and the Development of Stage 3 CKD: The Framingham Heart Study
, 28 April 2008
Meredith C. Foster, Shih-Jen Hwang, Martin G. Larson, Judith H. Lichtman, Nisha I. Parikh, Ramachandran S. Vasan, Daniel Levy, Caroline S. Fox
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 39-48)
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Waist-to-Hip Ratio and Body Mass Index as Risk Factors for Cardiovascular Events in CKD
, 03 June 2008
Essam F. Elsayed, Hocine Tighiouart, Daniel E. Weiner, John Griffith, Deeb Salem, Andrew S. Levey, Mark J. Sarnak
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 49-57)
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Obesity-Related Glomerulopathy in China: A Case Series of 90 Patients
, 23 April 2008
Hui-Mei Chen, Shi-Jun Li, Hui-Ping Chen, Qing-Wen Wang, Lei-Shi Li, Zhi-Hong Liu
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 58-65)
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Waist Circumference and Visceral Fat in CKD: A Cross-sectional Study
, 28 April 2008
Fabiana M.R. Sanches, Carla M. Avesani, Maria A. Kamimura, Marcelo M. Lemos, Jonas Axelsson, Priscila Vasselai, Sergio A. Draibe, Lilian Cuppari
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 66-73)
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Accuracy of Patients' Reports of Comorbid Disease and Their Association With Mortality in ESRD
, 03 April 2008
Kerri L. Cavanaugh, Sharon Stein Merkin, Laura C. Plantinga, Nancy E. Fink, John H. Sadler, Neil R. Powe
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 118-127)
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Association Between a Self-Rated Health Question and Mortality in Young and Old Dialysis Patients: A Cohort Study
, 30 May 2008
Melissa S.Y. Thong, Adrian A. Kaptein, Yael Benyamini, Raymond T. Krediet, Elisabeth W. Boeschoten, Friedo W. Dekker, Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) Study Group
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 111-117)
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Mutations in Proteins of the Alternative Pathway of Complement and the Pathogenesis of Atypical Hemolytic Uremic Syndrome
, 23 April 2008
Cynthia Abarrategui-Garrido, Marta Melgosa, Antonia Peña-Carrión, Elena Goicoechea de Jorge, Santiago Rodríguez de Córdoba, Margarita López-Trascasa, Pilar Sánchez-Corral
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 171-180)
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A Review of Drug-Induced Hyponatremia
, 13 May 2008
George Liamis, Haralampos Milionis, Moses Elisaf
American Journal of Kidney Diseases
July 2008 (Vol. 52, Issue 1, Pages 144-153)
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Obesity and CKD  See Ritz, pages 1-6. See also pages 29-73. Obesity is a risk factor for incident diabetes as well as cardiovascular events; however, the relationship between obesity and both subsequent kidney disease as well as cardiovascular outcomes in individuals with kidney disease is less certain, particularly given the distinct survival advantage among dialysis patients with a higher body mass index. This month in AJKD, a series of manuscripts assesses obesity in kidney disease, highlighting the diagnosis of obesity as well as the interplay among obesity, kidney disease, and outcomes. An editorial by Dr Ritz introduces this topic with 2 important observations: not all body fat is created equal with visceral fat conferring a substantially greater cardiovascular risk than subcutaneous fat, and both albuminuria and decreased GFR are manifestations of CKD that may be due to obesity. Among the 5 obesity-related articles in this issue of AJKD are a report from the Framingham Heart Study showing a 68% increased odds of developing CKD stage 3 among obese individuals, which was attenuated after multivariable adjustment as well as an 56% increased risk of incident dipstick proteinuria among obese individuals in adjusted models; reports from the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study demonstrating a significant relationship between waist-to-hip ratio but not body mass index and incident CKD in a generalizable US cohort as well as a significant relationship between waist-to-hip ratio but not body mass index and subsequent cardiovascular events and death among individuals with stage 3-4 CKD; a report from Sao Paolo, Brazil demonstrating better agreement between visceral fat and waist circumference than body mass index in a diverse CKD population; and a report from Nanjing, China reviewing 90 cases of obesity-related glomerulopathy on kidney biopsy between 2002 and 2006. Self-Reported Health and Mortality See Cavanaugh et al, pages 118-127 and Thong et al, pages 111-117. “The patient knows best” is a slogan that has gained increasing acceptance in modern medicine. Included this month are 2 large prospective cohort studies that explore this statement in dialysis patients. In data from the CHOICE Study, Cavanaugh et al report a higher risk of mortality among patients who inaccurately report their heart disease history. In data from 1,443 participants in the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD 2), Thong et al report that a patient's response to the simple question: “How would you say your health is in general?” is a strong, graded, independent predictor of mortality. Mutations in Factor H in aHUS See Aberrategui-Garrido et al, pages 171-180. Nearly half of all patients with atypical hemolytic uremic syndrome (aHUS) have mutations in the compliment proteins factor H, factor I, factor B, or C3, or in membrane cofactor protein. The prognosis in patients with these mutations, specifically a factor H mutation, is poor, and kidney transplant often fails in these individuals due to recurrent aHUS affecting the graft. Current therapy for aHUS requires rapid recognition of this disease; accordingly, most genetic studies are too time-consuming to guide initial therapy. In this month's In Translation feature, Abarrategui-Garrido et al describe a case of aHUS where an in vitro factor H-dependent hemolytic assay detected anomalous regulation of the alternative pathway, suggesting dysfunction of factor H; this was later confirmed with genetic testing. The authors then review recent advances in understanding molecular mechanisms contributing to aHUS and the benefits of functional analyses of factor H activity to guide treatment in aHUS patients. A Review of Drug-Induced Hyponatremia See Liamis et al, pages 144-153. Hyponatremia is the most common electrolyte disturbance in clinical practice and is associated with considerable morbidity and mortality. Many drugs are commonly associated with hyponatremia, including thiazide diuretics, antidepressants, and antiepilectics; notably, other newer agents have also been associated with hyponatremia, including antibiotics, proton pump inhibitors, and IVIg. In this issue, Liamis et al review the epidemiology and pathophysiology of drug-induced hyponatremia. PII: S0272-6386(08)00900-1 doi:10.1053/S0272-6386(08)00900-1 | |
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