Albuminúria and factors associated with chronic kidney disease in obesity

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.20490

Keywords:

Proteinuria; Albuminuria ; Chronic Renal Insufficiency; Risk factors; Bariatric Surgery; Morbid obesity.

Abstract

Introduction: Albuminuria is an important marker for increased morbidity and mortality in obese and a screening parameter for early renal changes. However, few studies associate the impact of obesity on albuminuria. Objective: To relate albuminuria and risk factors for chronic kidney disease with obesity. Methods: Cross-sectional study with obese patients, over 18 years old, without a diagnosis of chronic kidney disease, allocated according to the Body Mass Index, in groups A (30-39,99 kg/m² and 40-49 kg/m²) and B (≥50 kg/m² and ≥60 kg/m²). Renal evaluation occurs through the measurement of albuminuria, urea and creatinine. Lipid, inflammatory and glycemic profile were also evaluated. Chi-square, student t, Mann-Whitney and Spearman correlation tests were performed, with the Statistical Package for the Social Sciences software. The results were achieved with a significance level of p <0,05 and a 95% confidence interval. Results: 97 obese individuals had an albuminuria frequency of 21.6%, with no statistical difference between the groups. The decreased serum levels of HDL and increased CRP when related to the additional body mass index p <0,05. Of the risk factors, it was observed that the obese> 40 years old had a higher prevalence of hypertension. Albuminuria has a low correlation with age and body mass index (0,031 and 0,136, respectively). Conclusion: The frequency of albuminuria was high, but it was not associated with the severity of obesity. Obese middle-aged adults have more risk factors for kidney damage.

References

Barroso, T. A., Marins, L. B., Alves, R., Gonçalves, A. C. S., Barroso, S. G., & Rocha, G. S. (2017). Associação entre a obesidade central e a incidência de doenças e fatores de risco cardiovascular. Int J Cardiovasc Sci. 30 (5):416-24.

Bastos, M. G., Bregman, R., & Kirsztajn, G. M. (2010). Doença renal crônica: frequente e grave, mas também prevenível e tratável. Rev Assoc Med Bras. 56 (2):248-53.

Bhatt, V. R., Khese, V. B., Jadhav, S. L., & Kakrani, A. L. (2019). Urinary albumin excretion, estimated glomerular filtration rate, and prevalence of microalbuminuria in obese nondiabetic and nonhypertensive adults: A cross-sectional study. Indian J Nephrol. 29(3):166-71.

Brix, J. M., Herz, C. T., Kopp, H. P., Feder, A., Krzizek, E. C., Sperker, C., et al. (2019). Albuminuria in Patients with Morbid Obesity and the Effect of Weight Loss Following Bariatric Surgery. Obes Surg. 29(11):3581-8.

Chagnac, A., Weinstein, T., Korzets, A., Ramadan, E., Hirsch, J., & Gafter, U. (2000). Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol. 278(5):817-22.

Delors, J., Al-Mufti, I., Amagi, I., Carneiro, R., Chung, F., Geremek, B. et al. Educação: um tesouro a descobrir: relatório para a UNESCO da Comissão Internacional sobre Educação para o Século XXI. Brasília: UNESCO, 1998.

Ejerblad, E., Fored, C. M., Lindblad, P., Fryzek, J., McLaughlin, J. K., & Nyrén, O. (2006) Obesity and risk for chronic renal failure. J Am Soc Nephrology, 17(6):1695-1702.

Engin, A. B. & Engin, A. (2017) The pathogenesis of obesity-associated adipose tissue inflammation. Obesity and Lipotoxicity. Adv Exp Med Biol. 960:221-45.

Faludi, A. A., Izar, M. C. O., Saraiva, J. F. K., Chacra, A. P. M., Bianco, H. T., Afiune, Neto, A. et al. (2017). Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017. Arq Bras Cardiol. 9(2) 1:1-76.

Fantin, F., Giani, A., Zoico, E., Rossi, A. P., Mazzali, G., & Zamboni, M. (2019). Weight Loss and Hypertension in Obese Subjects. Nutrients. 11(7):1667.

Ferreira, A. P. S., Szwarcwald, C. L., & Damacena, G. N. (2019). Prevalência e fatores associados da obesidade na população brasileira: estudo com dados aferidos da Pesquisa Nacional de Saúde, 2013. Rev Bras Epidemiol. (22):e190024.

Futrakul, N., Sridama, V., & Futrakul, P. (2009). Microalbuminuria - a biomarker of renal microvascular disease. Ren Fail. 31(2):140-3.

Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 39(8):1423-34.

Herrington, W. G., Smith, M., Bankhead, C., Matsushita, K., Stevens, S., Holt, T., et al. (2017). Body-mass index and risk of advanced chronic kidney disease: prospective analyses from a primary care cohort of 1.4 million adults in England. PloS One, 12(3): e0173515.

Jura, M., Kozak, L. P. (2016). Obesity and related consequences to ageing. Age (Dordr), 38(1):23.

Kovesdy, C., Furth, S., Zoccali, C. (2017). World Kidney Day Steering Committee. Obesity and kidney disease: hidden consequences of the epidemic. J Bras Nefrol. 39(1):260-2.

Kuhnen, M., Boing, A. F., Oliveira, M. C. D., Longo, G. Z., Njaine, K. (2009). Tabagismo e fatores associados em adultos: um estudo de base populacional. Rev Bras Epidemiol. 12(4):615-26.

Lohman, T. G., Roche, A. F, Martorell, R. (1988). Anthropometric standardization reference manual. Champaign: Human Kinetics Books.

Malachias, M. V. B., Souza, W. K. S. B., Plavnik, F. L., Rodrigues, C. I. S., Brandão, A. A., Neves, M. F. T. (2016). 7º Diretriz Brasileira e Hipertensão Arterial. Arq Bras Cardiol. 107(3):1-103.

Márquez, D.F., Ruiz-Hurtado, G. Segura, J. Ruilope, L. (2019). Microalbuminuria and cardiorenal risk: old and new evidence in different populations. F1000Research, 8, F1000 Faculty Rev-1659.

Michels, W. M., Grootendorst, D. C., Verduijn, M., Elliott, E. G., Dekker, F. W., Krediet, R. T. (2010). Performance of Cockcroft-Gault, MDRD and CKD-EPI formulas in relation to GFR, age and body size. Clin J Am Soc Nephrol. 5(6):1003-9.

Minoo, F., Mahdavi-Mazdeh, M., Abbasi, M. R., Sohrabi, S. (2015). Impact of the severity of obesity on microalbuminuria in obese normotensive nondiabetic individuals. J Renal Inj Prev. 4(2):34-8.

Navarro, G., Ardiles, L. (2015). Association between obesity and chronic renal disease. Rev Med Chile, 143(1):77-84.

Park, K. H., Yadav, D., Kim, S. J., Kim, J. R., Cho, K. H. (2018). Slim body weight is highly associated with enhanced lipoprotein functionality, higher HDL-C, and large HDL particle size in young women. Front Endocrinol. 9:406.

Pellegrinelli, V., Carobbio, S., Vidal‐Puig, A. (2016) Adipose tissue plasticity: how fat depots respond differently to pathophysiological cues. Diabetologia, 59 (6):1075‐88.

Pinto-Sietsma, S. J., Navis, G., Janssen, W. M., Zeeuw, D., Gans, R. O, Jong, P. E. (2003). PREVEND Study Group. A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Diseases,41(4):733-41.

Renquist, K. (1997). Obesity classification. Obes Surgery, 7(6):523.

Rosenstock, J. L., Pommier, M., Stoffels, G., Patel, S., Michelis, M. F. (2018). Prevalence of proteinuria and albuminuria in an obese population and associated risk factors. Front Med. 5:122.

Serra, A., Romero, R., Lopez, D., Navarro, M., Esteve, A., Perez, N., et al. (2008) Renal injury in the extremely obese patients with normal renal function. Kidney Int. 2008;73(8):947-55.

Silva, P. M. C., Cabral Junior, C. R., & Vasconcelos, S. M. L. (2010). Ingestão do cálcio na obesidade de mulheres atendidas pelo Sistema Único de Saúde. Rev Nutr. 23(3):357-67.

Sociedade Brasileira de Diabetes (SBD). (2019). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. Sociedade Brasileira de Diabetes, p.1-491.

Stenvinkel, P., Zoccali, C., & Ikizler, T. A. (2013). Obesity in CKD – what should nephrologists know? J Am Soc Nephrology, 24 (11):1727-36.

Teliewubai, J., Fan, X., Ji, H., Maimaitiaili, R., Tang, J., Zhao, S., et al. (2020). Does healthy obesity exist in the elderly? Findings from the Northern Shanghai Study. Nutr Metab Cardiovasc Dis. 30(5):749-57.

Unamuno, X., Gómez‐Ambrosi, J., Rodríguez, A., Becerril, S., Frühbeck, G., & Catalán, V. (2018) Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Invest. 48(9): e12997.

Valensi, P., Assayag, M., Busby, M., Paries, J., Lormeau, B., & Attali, J.R. Microalbuminuria in obese patients with or without hypertension. Int J Obes Relat Metab Disord. 1996;20(6):574-9.

WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363 (9403):157-63.

Yazdani, N., Sharif, F., Elahi, N., Hosseini, S.V., & Ebadi, A. (2019). Exploration of the Quality of Life in Iranian Morbid Obese People: A Qualitative study. Int J Community Based Nurs Midwifery, 7(2):138-49.

Zanella, M. T. Microalbuminúria: fator de risco cardiovascular e subestimado na prática clínica. (2006). Arq Bras Endocrinol Metab. 50(2):313-21.

Published

21/09/2021

How to Cite

MEDEIROS, V. C. de .; ALBUQUERQUE, C. M. R.; DIAS, C. . de A.; OLIVEIRA, A. C. M. de; SANTOS, J. C. de F. . Albuminúria and factors associated with chronic kidney disease in obesity. Research, Society and Development, [S. l.], v. 10, n. 12, p. e316101220490, 2021. DOI: 10.33448/rsd-v10i12.20490. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20490. Acesso em: 20 feb. 2024.

Issue

Section

Health Sciences