Fotheringham, J., Kawar, B., McKane, W. et al. (1 more author) (2017) Obesity modulates the association between systolic blood pressure and albuminuria. Nephrology Dialysis Transplantation. ISSN 0931-0509
Abstract
Background. Obesity is associated with albuminuria and incident kidney disease. Increased vulnerability of the glomerular microcirculation to elevated systemic blood pressure is postulated to contribute to adverse effects of obesity on the kidney. We therefore hypothesized that obesity would modulate the association between systolic blood pressure (sBP) and albuminuria.
Methods. The relationship between obesity and albuminuria [fractional albumin excretion (FEalb) or albumin:creatinine ratio (ACR)] was modelled using linear/logistic regression in the US National Health and Nutrition Examination Survey 1999–2010 cohorts (N = 23 710). Associations between sBP and albuminuria were examined across strata of waist circumference and body mass index (BMI) using interaction terms.
Results. Obesity was associated with albuminuria through an interaction with sBP. Among participants in the 4th/5th quintiles of waist circumference each 10 mmHg increase in sBP was accompanied by approximately double the increment in FEalb observed among those in quintile 2 (14% versus 7%, P < 0.001). There was also evidence of a lower sBP threshold for the relationship between sBP and albuminuria in obesity. While FEalb increased with sBP >110 mmHg in quintile 5 of waist circumference, in quintile 2 FEalb did not increase until sBP was >130 mmHg. Findings were consistent when defining obesity by BMI or waist circumference and when quantifying albuminuria by ACR or FEalb. Assessing albuminuria as the odds ratio of ACR >30 mg/g also gave similar results.
Conclusion. The interaction between sBP and obesity supports the premise that obesity sensitizes the kidney to increased systemic blood pressure.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | This is a pre-copyedited, author-produced version of an article accepted for publication in Nephrology Dialysis Transplantation following peer review. The version of record James Fotheringham, Bisher Kawar, William McKane, Timothy Ellam; Obesity modulates the association between systolic blood pressure and albuminuria. Nephrol Dial Transplant 2017 gfx081 is available online at https://doi.org/10.1093/ndt/gfx081. |
Keywords: | albuminuria; blood pressure; CKD; hypertension; obesity |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 04 Jul 2017 13:39 |
Last Modified: | 30 May 2018 00:39 |
Published Version: | https://doi.org/10.1093/ndt/gfx081 |
Status: | Published online |
Publisher: | Oxford University Press |
Refereed: | Yes |
Identification Number: | https://doi.org/10.1093/ndt/gfx081 |