Body fat percentagem and body mass index predispose chronic kidney disease patients to variations on blood biomarkers




Chronic Kidney Disease; Body Mass Index; Adiposity; Biomarkers.


Objective: To analyze variations of biomarkers with different body mass index (BMI) and body fat percentage (% BF). Methods: Cross-sectional study, comprising 173 patients with CKD. Twenty blood biomarkers were evaluated. BMI was categorized as eutrophic and overweight. % BF was assessed by air displacement plethysmography and rated high when ≥25% for men and ≥32% for women. Four groups were categorized: eutrophic (adequate BMI and % BF), normal-weight obese (adequate BMI and high % BF), overweight and adequate % BG (high BMI and normal % BF) and real obese (BMI and% BF high). Results: Compared to eutrophic individuals, the “normal-weight obese” registered lower hemoglobin (12.5 mg / dl) and hematocrit (37.0%), higher values for phosphorus (3.6 mg / dl), CRP (0.2 mg / dL) and fasting blood glucose (105.5 mg / dL). The “real obese” had lower creatinine (1.6 mg / dL) and higher triglycerides (159 mg / dL), CRP (0.3 mg / dL) and fasting glucose (101 mg/dL). The group “overweight and adequate% BF” showed higher triglycerides (217 mg / dL) blood glucose (108mg / dL) and lower HDL-c (33.9 mg / dL). Conclusions: The “obese of normal weight” showed more variations on the biomarkers. The “overweight and adequate% BF” and “real obese” groups had higher serum values for some parameters. The need to assess combined parameters is emphasized, as both BMI and% BF can influence biochemical markers.


Ahmadi, S. F., Zahmatkesh, G., Ahmadi, E., Streja, E., Rhee, C. M., Gillen, D. L., & Kalantar-Zadeh, K. (2016). Association of body mass index with clinical outcomes in non-dialysis-dependent chronic kidney disease: a systematic review and meta-analysis. Cardiorenal medicine, 6(1), 37-49.

Bellissimo, M. P., Bettermann, E. L., Tran, P. H., Crain, B. H., Ferranti, E. P., Binongo, J. N., Hartman, T. J., Jones, D. P., Ziegler, T. R., & Alvarez, J. A. (2020). Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults. Journal of the Academy of Nutrition and Dietetics, 120(12), 1963–1973.e2.

Billington, E. O., Gamble, G. D., Bristow, S., & Reid, I. R. (2017). Serum phosphate is related to adiposity in healthy adults. European Journal of Clinical Investigation, 47(7), 486-493.

Bragança, M. L. B. M., Oliveira, B. R. D., Fonseca, J. M., Batalha, M. A., Bogea, E. G., Coelho, C. C. N. D. S., & Silva, A. A. M. D. (2020). Avaliação do perfil de biomarcadores sanguíneos em adolescentes classificados pelo índice de massa corporal e percentual de gordura corporal. Cadernos de Saúde Pública, 36.

Declèves, A. E., & Sharma, K. (2015). Obesity and kidney disease: differential effects of obesity on adipose tissue and kidney inflammation and fibrosis. Current opinion in nephrology and hypertension, 24(1), 28.

Delanaye, P., Cavalier, E., & Pottel, H. (2017). Serum creatinine: not so simple!. Nephron, 136(4), 302-308.

Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.

Ferro, C. J., Mark, P. B., Kanbay, M., Sarafidis, P., Heine, G. H., Rossignol, P., & Zoccali, C. (2018). Lipid management in patients with chronic kidney disease. Nature Reviews Nephrology, 14(12), 727-749.

Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical chemistry, 18(6), 499–502.

Fung, E., & Tamura, M. K. (2016). Epidemiology and public health concerns of CKD in older adults. Advances in chronic kidney disease, 23(1), 8-11.

Garagarza, C., Valente, A., Caetano, C., Oliveira, T., Ponce, P., & Silva, A. P. (2017). Hypophosphatemia: nutritional status, body composition, and mortality in hemodialysis patients. International Urology and Nephrology, 49(7), 1243-1250.

Guligowska, A., Corsonello, A., Pigłowska, M., Roller-Wirnsberger, R., Wirnsberger, G., Ärnlöv, J., & Kostka, T. (2020). Association between kidney function, nutritional status and anthropometric measures in older people. BMC geriatrics, 20(1), 1-12.

Hauschild¹, D. B., Schieferdecker¹, M. E., Leite¹, C. M., & do Nascimento¹, M. M. (2014). Composição corporal de pacientes com doença renal crônica em tratamento conservador Rev. Med. UFPR, 1(2), 47-53.

Helal, I., Fick-Brosnahan, G. M., Reed-Gitomer, B., & Schrier, R. W. (2012). Glomerular hyperfiltration: definitions, mechanisms and clinical implications. Nature Reviews Nephrology, 8(5), 293-300.

Kalantar-Zadeh, K., Rhee, C. M., Chou, J., Ahmadi, S. F., Park, J., Chen, J. L., & Amin, A. N. (2017). The obesity paradox in kidney disease: how to reconcile it with obesity management. Kidney international reports, 2(2), 271-281.

Kosmas, C. E., Silverio, D., Tsomidou, C., Salcedo, M. D., Montan, P. D., & Guzman, E. (2018). The Impact of Insulin Resistance and Chronic Kidney Disease on Inflammation and Cardiovascular Disease. Clinical medicine insights. Endocrinology and diabetes, 11, 1179551418792257.

Kovesdy, C. P., Furth, S. L., Zoccali, C., & World Kidney Day Steering Committee (2017). Obesity and kidney disease: hidden consequences of the epidemic. Journal of nephrology, 30(1), 1–10.

Lakkis, J. I., & Weir, M. R. (2018). Obesity and Kidney Disease. Progress in cardiovascular diseases, 61(2), 157–167.

Levey, A. S., Stevens, L. A., Schmid, C. H., Zhang, Y. L., Castro, A. F., 3rd, Feldman, H. I., Kusek, J. W., Eggers, P., Van Lente, F., Greene, T., Coresh, J., & CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) (2009). A new equation to estimate glomerular filtration rate. Annals of internal medicine, 150(9), 604–612.

Levin, A., Stevens, P. E., Bilous, R. W., Coresh, J., De Francisco, A. L., De Jong, P. E., & Winearls, C. G. (2013). Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney international supplements, 3(1), 1-150.

Lin, C. Y., Hsieh, M. C., Kor, C. T., & Hsieh, Y. P. (2019). Association and risk factors of chronic kidney disease and incident diabetes: a nationwide population-based cohort study. Diabetologia, 62(3), 438-447.

Lin, T. Y., Lim, P. S., & Hung, S. C. (2018). Normal-weight obesity and clinical outcomes in nondiabetic chronic kidney disease patients: a cohort study. The American Journal of Clinical Nutrition, 107(4), 664–672.

Lipschitz D. A. (1994). Screening for nutritional status in the elderly. Primary care, 21(1), 55–67.

Lohman, T. G., Roche, A. F., & Martorell, R. (1988). Anthropometric standardization reference manual. Human kinetics books.

Mascali, A., Franzese, O., Nistico, S., Campia, U., Lauro, D., Cardillo, C., & Tesauro, M. (2016). Obesity and kidney disease: Beyond the hyperfiltration. International Journal of Immunopathology and Nharmacology, 29(3), 354-363.

McCrory, M. A., Gomez, T. D., Bernauer, E. M., & Molé, P. A. (1995). Evaluation of a new air displacement plethysmograph for measuring human body composition. Medicine and Science in Sports and Exercise, 27(12), 1686–1691.

Mikolasevic, I., Žutelija, M., Mavrinac, V., & Orlic, L. (2017). Dyslipidemia in patients with chronic kidney disease: etiology and management. International Journal of Nephrology and Renovascular Disease, 10, 35.

Obeid, O. A. (2013). Low phosphorus status might contribute to the onset of obesity. Obesity reviews, 14(8), 659-664.

Pascual, V., Serrano, A., Pedro-Botet, J., Ascaso, J., Barrios, V., Millán, J., & Cases, A. (2017). Enfermedad renal crónica y dislipidemia. Clínica e Investigación en Arteriosclerosis, 29(1), 22-35.

Patel, S. S., Molnar, M. Z., Tayek, J. A., Ix, J. H., Noori, N., Benner, D., & Kalantar-Zadeh, K. (2013). Serum creatinine as a marker of muscle mass in chronic kidney disease: results of a cross-sectional study and review of literature. Journal of Cachexia, Sarcopenia and Muscle, 4(1), 19-29.

Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. (1995). World Health Organization Technical Report Series, 854, 1–452.

Piéroni, L., Bargnoux, A. S., Cristol, J. P., Cavalier, E., & Delanaye, P. (2017). Did creatinine standardization give benefits to the evaluation of glomerular filtration rate?. Ejifcc, 28(4), 251.

Ramos, L. F., Shintani, A., Ikizler, T. A., & Himmelfarb, J. (2008). Oxidative stress and inflammation are associated with adiposity in moderate to severe CKD. Journal of The American Society of Nephrology, 19(3), 593-599.

Rao, W., Su, Y., Yang, G., Ma, Y., Liu, R., Zhang, S., & Yu, Q. (2016). Cross-sectional associations between body mass index and hyperlipidemia among adults in northeastern China. International Journal of Environmental Research and Public Health, 13(5), 516.

Rapa, S. F., Di Iorio, B. R., Campiglia, P., Heidland, A., & Marzocco, S. (2019). Inflammation and Oxidative Stress in Chronic Kidney Disease-Potential Therapeutic Role of Minerals, Vitamins and Plant-Derived Metabolites. International Journal of Molecular Sciences, 21(1), 263.

Silva, C. L. Á. D., Lima-Costa, M. F., Firmo, J. O. A., & Peixoto, S. V. (2012). Nível de hemoglobina entre idosos e sua associação com indicadores do estado nutricional e uso de serviços de saúde: Projeto Bambuí. Cadernos de Saúde Pública, 28, 2085-2094.

Siri W. E. (1993). Body composition from fluid spaces and density: analysis of methods. 1961. Nutrition (Burbank, Los Angeles County, Calif.), 9(5), 480–492.

Tokumaru, T., Toyama, T., Hara, A., Kitagawa, K., Yamamura, Y., Nakagawa, S., & Wada, T. (2020). Association between Unhealthy Dietary Habits and Proteinuria Onset in a Japanese General Population: A Retrospective Cohort Study. Nutrients, 12(9), 2511.

Trirogoff, M. L., Shintani, A., Himmelfarb, J., & Ikizler, T. A. (2007). Body mass index and fat mass are the primary correlates of insulin resistance in nondiabetic stage 3–4 chronic kidney disease patients. The American Journal of Clinical Nutrition, 86(6), 1642-1648.

Tsuruya, K., Yoshida, H., Nagata, M., Kitazono, T., Iseki, K., Iseki, C., & Watanabe, T. (2015). Impact of the triglycerides to high-density lipoprotein cholesterol ratio on the incidence and progression of CKD: a longitudinal study in a large Japanese population. American Journal of Kidney Diseases, 66(6), 972-983.

Vassalotti, J. A., Centor, R., Turner, B. J., Greer, R. C., Choi, M., Sequist, T. D., & National Kidney Foundation Kidney Disease Outcomes Quality Initiative (2016). Practical Approach to Detection and Management of Chronic Kidney Disease for the Primary Care Clinician. The American Journal of Medicine, 129(2), 153–162.e7.

Zohal, M., Jam-Ashkezari, S., Namiranian, N., Moosavi, A., & Ghadiri-Anari, A. (2019). Association between selected trace elements and body mass index and waist circumference: A cross sectional study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(2), 1293-1297.



How to Cite

OLIVEIRA, M. T. dos S. de; BRAGANÇA, M. L. B. M.; DIAS, R. S. C.; CARNEIRO, E. C. R. de L.; SANTOS, E. M.; FRANÇA, A. K. T. C.; FURTADO, E. V. H.; MATOS, H. R. de; SALGADO FILHO, N.; BERNARDO-FILHO, M. Body fat percentagem and body mass index predispose chronic kidney disease patients to variations on blood biomarkers. Research, Society and Development, [S. l.], v. 11, n. 10, p. e570111033207, 2022. DOI: 10.33448/rsd-v11i10.33207. Disponível em: Acesso em: 30 nov. 2022.



Health Sciences