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Body mass index modifies the effect of urinary protein-to-creatinine ratio on chronic kidney disease progression

  • Nephrology - Original Paper
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Abstract

Background

This study aimed to determine the association between the urinary protein-to-creatinine ratio (UPCR) and chronic kidney disease (CKD) progression in a cohort study, and to determine whether body mass index (BMI) modifies this association.

Methods

The study population consisted of 856 hypertensive patients with CKD stages 2–5, enrolled between 2010 and 2011 in Japan. Generalized linear models with a logit link were used to evaluate the independent and combined effects of the UPCR and BMI on CKD progression

Results

During a median follow-up of 25 months, 242 patients developed CKD progression during follow-up. A notably higher risk of CKD progression was found in participants in tertiles 2 [odds ratio (OR): 5.46, 95% confidence interval (95% CI): 2.49–11.99] and 3 (OR 27.74, 95% CI 12.34–62.38) comparing with tertiles 1 for UPCR levels. Moreover, an interaction was found between UPCR and BMI on CKD progression (P for interaction = 0.006). Participants in both the highest tertile of UPCR and overweight (UPCR ≥ 248.9 mg/mmol and BMI ≥ 25 kg/m2) had a 45.59-times higher risk of CKD progression compared with those in the lowest tertile of UPCR and nonoverweight (UPCR < 36.2 mg/mmol and BMI < 25 kg/m2)

Conclusions

The present study demonstrates that the combination of elevated UPCR and BMI may contribute to an increased risk of CKD progression.

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Data availability

The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/Supplementary Material.

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Acknowledgements

As this is a secondary analysis, the data and method description are mainly derived from the following research (14). We are grateful to all the authors of the study.

Funding

The study was supported by funding from the following: National Natural Science Foundation of China (No. 82160139) and the Science and Technology Project of the Education Department of Jiangxi Province (No. GJJ190059).

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi, People’s Republic of China

    Jiancheng Wang, Qiwei Fan, Ying Hu, Lingyan Zhu & Jixiong Xu

  2. Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, 330006, Jiangxi, People’s Republic of China

    Jiancheng Wang, Qiwei Fan, Ying Hu, Lingyan Zhu & Jixiong Xu

  3. Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, 330006, Jiangxi, People’s Republic of China

    Jiancheng Wang, Qiwei Fan, Ying Hu, Lingyan Zhu & Jixiong Xu

Authors
  1. Jiancheng Wang
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  2. Qiwei Fan
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  3. Ying Hu
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  4. Lingyan Zhu
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  5. Jixiong Xu
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Contributions

Jixiong Xu, and Jiancheng Wang conceived and/or designed the study; Ying Hu, and Qiwei Fan acquired data; Jiancheng Wang, Qiwei Fan, Ying Hu, Lingyan Zhu, and Jixiong Xu played an important role in interpreting the results; Jiancheng Wang, and Lingyan Zhu drafted or revised the manuscript; and Jixiong Xu approved the final version.

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Correspondence to Jiancheng Wang or Jixiong Xu.

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Wang, J., Fan, Q., Hu, Y. et al. Body mass index modifies the effect of urinary protein-to-creatinine ratio on chronic kidney disease progression. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03984-z

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