Highlights
- •There is no consensus formula for measuring glomerular filtration rate in obesity.
- •Obesity is not always associated with renal hyperfiltration.
- •Obesity-associated diastolic dysfunction may precede chronic kidney disease.
Abstract
Background
A robust and consistent association between increasing body mass index (BMI) and chronic
kidney disease (CKD) has been reported in several observational studies. Obesity remains
the main preventable risk factor for CKD because it largely mediates diabetes and
hypertension, the 2 most common etiologies for end-stage kidney disease (ESKD). Obesity
is associated weakly with early stages of kidney disease but strongly with kidney
progression to ESKD, even after adjustment for hypertension and diabetes.
Aim
To assess the relationship between estimated glomerular filtration rate (eGFR) and
trans-thoracic echocardiography left ventricular function parameters in a cohort of
patients with obesity.
Materials & methods
Cross-sectional study involving 324 obese (BMI = 44.0 ± 2.2 Kg/m2) apparently healthy asymptomatic patients with an eGFR >60 ml/min/1.73 m2. Each patient underwent transthoracic echocardiography and a blood testing. The eGFR
was addressed by the CKD-EPI formula.
Results
All patients had a normal systolic function whereas 24.5% disclosed diastolic dysfunction
(DD). Hypertension and type 2 diabetes mellitus prevalence were 34.5% and 4.5% (respectively).
All patients disclosed an eGFR >60 ml/min while none of them disclosed hyperfiltration (eGFR >120 ml/min). eGFR correlated inversely with BMI and the duration of obesity and positively
with diastolic function parameters (P < 0.001 for all, respectively). Patients with diastolic dysfunction displayed lower
eGFR (P < 0.0005) and longer duration of obesity (P < 0.0005).
Conclusions
Obesity and its duration are likely to impose hemodynamic changes affecting simultaneously
both heart (diastolic dysfunction) and kidney (decreased glomerular filtration rate).
Larger prospective studies are warranted.
Keywords
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Article info
Publication history
Published online: February 27, 2016
Accepted:
February 14,
2016
Received in revised form:
February 3,
2016
Received:
December 4,
2015
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
