INFLAMMATION IS ASSOCIATED WITH EXCESSIVE BODY ADIPOSITY IN NONDIALYSED CHRONIC KIDNEY DISEASE (CKD) PATIENTS

• Main Authors: Maria Inês Barreto-Silva, Carla Avesani, Laura Kawakami, Renata Martucci, Rachel Bregman
• Format: Article
• Language: English
• Published: The Korean Society of Nephrology 2012-06-01
• Series: Kidney Research and Clinical Practice
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211913212003701

The purpose of this study was to evaluate inflammation in non-dialysed CKD patients with normal and high body adiposity level. One hundred and thirty four CKD patients (male: 56%; age=65±12 years) under treatment for 3.0±2.0 years were evaluated in a cross-sectional study. Glomerular filtration rate (eGFR) was estimated by MDRD equation. Body adiposity was assessed by BMI and total body fat (BF; dual-energy X-ray absorptiometry). Laboratorial measurements were: albumin, pro-inflammatory cytokines by Multiplexed analysis: tumor necrosis factor-α, interferon-γ, high sensitive C reactive protein, monocyte chemotactic protein, inteleukine 6 and 8, intercellular adhesion molecule-1 and vascular adhesion molecule-1. The inflammation status was defined according to the median values for each studied pro-inflammatory cytokines: negative for inflammation (Infl-) (< median), positive for inflammation (Infl+) (≥ median). The cytokines were compared between patients with normal BMI (<25kg/m2) (46%; BMI=22.2±1.9) and high BMI (≥25kg/m2) (BMI=28.8±2.8). Both groups showed similar eGFR and CKD stages distribution (stage 3:42%, 4: 37%, 5: 21%). BF and all cytokines were higher in high BMI group than in normal BMI (P<0.0001). BMI and BF were correlated (r= 0.74; P<0.0001). The Infl+ condition was more prevalent, for all cytokines, in the high BMI group (range:61–76%) than in normal (24–38%). Multivariate logistic regression analysis, for all cytokines, showed that Infl+ condition was associated with high BMI (Odds Ratio range: 2.5–4.2; 95%CI: 1.1 - 9.6; P<0.01), even after adjusted for age, gender, diabetes and eGFR. In conclusion, CKD patients with high BMI and body adiposity are at higher risk for inflammation. Therefore, the excess of adiposity should be carefully treated in these patients.