Body-mass index and the risk of albuminuria in hypertensive patients with a poor estimated glomerular filtration rate and the potential role of diabetes mellitus

Background: Obesity-related to metabolic syndrome was associated with a greater risk for development of chronic kidney disease (CKD). We aimed to assess the association between obesity and micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m(2). Methods: One hundred old patients (median age 79 years +/- inter-quartile range 68-84.7) with manifested hypertension (systolic blood pressure >= 130 mmHg and/or diastolic blood pressure >= 85mmHg) and a permanently poor eGFR for a duration time more than 3 months were enclosed. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) >= 30 mg/gr and it was classified according to KDIGO 2012. The obesity was defined by a high body mass index (BMI>30 kg/m(2)). The waist circumference, HDL-C, triglycerides and serum glucose were measured. Chi-square tests and an adjusted model were performed. Results: Chi-square tests showed significant association between classified albuminuria and both obesity and high serum triglycerides (x(2) = 7.2, p = 0.02 and x(2) = 8.3, p = 0.01 respectively). However, the adjusted model for the prediction of albuminuria showed that the presence of a high BMI was a nonsignificant risk factor, although diabetes mellitus and eGFR value were found to be significant risk factors (p = 0.03, OR = 4.3, 1.2-22.07 and p = 0.04, OR = 0.9, 0.9-1.007 respectively) adjusting to covariates including the high waist circumference. Conclusion: Obesity defined by a high BMI was not found to be a significant risk factor for micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate, when diabetes mellitus and the low eGFR value act as confounders. (c) 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.