Predicted Lean Body Mass and the Risk of Adverse Kidney Outcomes in Men

Yuta Suzuki; Hidehiro Kaneko; Tatsuhiko Azegami; Akira Okada; Toshiyuki Ko; Katsuhito Fujiu; Norifumi Takeda; Hiroyuki Morita; Takashi Yokoo; Koichi Node; Kaori Hayashi; Issei Komuro; Hideo Yasunaga; Masaomi Nangaku; Norihiko Takeda

doi:10.1053/j.jrn.2026.01.001

Predicted Lean Body Mass and the Risk of Adverse Kidney Outcomes in Men

J Ren Nutr. 2026 Jan 16:S1051-2276(26)00001-4. doi: 10.1053/j.jrn.2026.01.001. Online ahead of print.

Authors

Affiliations

¹ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan.
² Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan. Electronic address: kanekohidehiro@gmail.com.
³ Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
⁴ Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁵ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
⁷ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁸ Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
⁹ Department of Cardiovascular Medicine, Saga University, Saga, Japan.
¹⁰ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; International University of Health and Welfare, Tokyo, Japan.
¹¹ Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
¹² Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.

PMID: 41548625
DOI: 10.1053/j.jrn.2026.01.001

Abstract

Objective: There are limited clinical data on whether low lean body mass is a risk factor for adverse kidney outcomes. We aimed to investigate the association between lean body mass, derived from a simple formula, and adverse kidney outcomes in men.

Methods: This cohort study utilized nationwide data from the DeSC database, encompassing a total of 468,597 men. The components for predicting lean body mass include age, height, body weight, waist circumference, and ethnicity. The primary outcome was a decrease in estimated glomerular filtration rate (eGFR) ≥ 40% from the baseline measurement.

Results: During a mean follow-up of 4.0 years, a decrease in eGFR of ≥40% was observed in 2,047 individuals. Individuals in tertile 1 of predicted lean body mass had a higher risk of a decrease in eGFR of ≥40% than those in tertile 3 (hazard ratio, 1.54; 95% confidence interval, 1.33-1.78). In cubic spline analysis, the hazard ratio was observed to decrease progressively with higher predicted lean body mass up to the median level, after which it plateaued. The significant association between lower predicted lean body mass and the risk of eGFR of ≥40% was generally consistent across subgroups stratified by baseline characteristics, including eGFR levels.

Conclusion: Men with lower predicted lean body mass had a higher risk of adverse kidney outcome. Our results suggest the clinical importance of lean body mass assessment for kidney disease risk stratification.

Keywords: epidemiology; kidney outcome; lean body mass.