A recent study conducted using data from the National Health and Nutrition Examination Survey (NHANES) shed new light on the link between obesity and chronic kidney disease (CKD). The study published in the BMC Nephrology, aimed at investigating the potential association between weight-adjusted waist index (WWI) and CKD, has found WWI to be a superior predictor of CKD and albuminuria when compared to other obesity indicators.

The study, which involved 40,421 participants between 1999 and 2020, defined CKD as a low estimated glomerular filtration rate (eGFR) or the presence of albuminuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30mg/g). Low-eGFR was characterized as eGFR < 60 mL/min/1.73m². The research utilized generalized additive models and weighted multivariable logistic regression models to analyze the associations between WWI, CKD, albuminuria, and low-eGFR, alongside other obesity indicators such as body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC), height, and weight. Receiver operating characteristic (ROC) curves were employed to assess diagnostic abilities.
Key findings from the study include:
CKD was prevalent among 16.71% of the study participants, while albuminuria and low-eGFR were present in 10.97% and 7.63% of cases, respectively.
WWI demonstrated a strong positive association with CKD (OR = 1.42; 95% CI: 1.26, 1.60) and albuminuria (OR = 1.60; 95% CI: 1.40, 1.82).
Smooth curve fitting revealed a nonlinear relationship between WWI and CKD.
Subgroup analysis and interaction tests showed consistent results across different stratifications.
Higher height was linked to a higher prevalence of low-eGFR (OR = 1.05; 95% CI: 1.03, 1.06).
ROC analysis demonstrated that WWI had the best discrimination and accuracy for predicting CKD and albuminuria compared to other obesity indicators (BMI, WHtR, WC, height, and weight). Height had the highest area under the curve (AUC) value for predicting low-eGFR.
As the prevalence of obesity continues to rise globally, understanding the impact of different obesity indicators on kidney health becomes crucial. The study also emphasizes the importance of considering height in assessing the risk of low eGFR. Further research in this area could lead to improved early detection and management of CKD, ultimately reducing the burden of kidney disease in the population.
Source:
Li, X., Wang, L., Zhou, H., & Xu, H. (2023). Association between weight-adjusted-waist index and chronic kidney disease: a cross-sectional study. In BMC Nephrology (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-023-03316-w