Weight Cycling Linked With Poor Outcomes in Chronic Kidney D
Large fluctuations in body mass index (BMI) over time -- otherwise known as weight cycling -- were associated with poorer outcomes in patients with chronic kidney disease (CKD), according to an observational study.

The association between variabilities in body mass index (BMI) or metabolic parameters and prognosis of patients with CKD has rarely been studied.

In this retrospective observational study on the basis of South Korea’s national health screening database, researchers identified individuals who received more than 3 health screenings, including those with persistent predialysis CKD (eGFR less than 60 ml/min per 1.73 m2 or dipstick albuminuria more than 1). The study exposure was variability in BMI or metabolic parameters until baseline assessment, calculated as the variation independent of the mean and stratified into quartiles (with Q4 the highest quartile and Q1 the lowest). They used Cox regression adjusted for various clinical characteristics to analyze risks of all-cause mortality and incident myocardial infarction, stroke, and KRT.

-- The study included 84,636 patients with predialysis CKD.

-- Comparing Q4 versus Q1, higher BMI variability was significantly associated with higher risks of all-cause mortality, KRT, myocardial infarction, and stroke.

-- The results were similar in the subgroups divided according to positive or negative trends in BMI during the exposure assessment period.

-- Variabilities in certain metabolic syndrome components (e.g., fasting blood glucose) also were significantly associated with prognosis of patients with predialysis CKD.

-- Those with a higher number of metabolic syndrome components with high variability had a worse prognosis.

Conclusively, higher variabilities in BMI and certain metabolic syndrome components are significantly associated with a worse prognosis in patients with predialysis CKD.

Source: https://jasn.asnjournals.org/content/early/2021/08/12/ASN.2020121694