Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil)

J Am Nutr Assoc. 2022 Mar-Apr;41(3):275-280. doi: 10.1080/07315724.2021.1878968. Epub 2021 Feb 19.


Introduction: Chronic kidney disease (CKD) is a public health problem and it is associated with a high risk of mortality. Overweight and obesity are known as independent risk factors for CKD.

Objective: To investigate the association between adiposity indexes and kidney disease.

Methods: This study included 14,636 adults from ELSA-Brazil. Outcome variables: altered glomerular filtration rate (GFR), categorized as yes (GFR <60 mL/min/1.73 m2) and no (GFR ≥60 mL/min/1.73 m2), albuminuria, estimated by albumin-creatinine ratio and categorized as yes (≥30 mg/g) and no (<30 mg/g), and presence of chronic kidney disease (CKD) (altered GFR and/or albuminuria). Exposure variables: obesity and overweight (body mass index (BMI)≥30 and ≥25 kg/m2, respectively), high waist circumference (WC) (≥102 cm in men and ≥88 cm in women), high waist-to-hip ratio (WHR) (≥0.90 in men and ≥0.85 in women), and high waist-to-height ratio (WHtR) (≥0.5). To estimate the association between main exposures and outcomes, logistic regression analyses were performed using models adjusted for sociodemographic variables (age, gender, race/skin color, education), behavioral (smoking, physical activity, alcohol consumption), components of the metabolic syndrome (HDL cholesterol, triglycerides, hypertension, diabetes mellitus) and history of cardiovascular disease (myocardial infarction, angina or heart failure).

Results: Individuals with obesity, high WC, WHR and WHtR were more prone to albuminuria when compared to individuals with normal values for these measures. It was also observed that these altered measures were positively associated with the presence of CKD.

Conclusion: Adiposity indexes have a direct and significant association with albuminuria and CKD.

Keywords: Obesity; albuminuria; chronic kidney disease; glomerular filtration rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity*
  • Adult
  • Albuminuria / epidemiology
  • Brazil / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Obesity / complications
  • Overweight / complications
  • Renal Insufficiency, Chronic* / epidemiology