Wael Nassar, Mervat El-ansary, Mostafa Abdel-aziz Mostafa, Tarek Fayad, Esam Kotb, Mahmoud Temraz, Abdel-Naser Saad, Wael Essa
Objective There is a growing appreciation that even in the absence of hypertension and diabetes, obesity itself is a significant risk factor of chronic kidney disease. Methods In a cross sectional, observational multi centers study, three hundred seventy two (n=372) chronic kidney disease patients with stage III and IV (eGFR 20-60 ml/min/m2) have been enrolled in this study. Lean Group I; 153 non diabetic chronic kidney disease patients aged 20-40 years with body mass index between 20-25 kgm/m2; obese Group II; 130 non diabetic chronic kidney disease patients aged 20-40 years with body mass index >30 kgm/m2 and old aged Group III; 89 chronic kidney disease patients aged >60 years. Obese Group II showed significant increase of the ALD/PRA ratio when compared with both other groups; lean Group I (P<0.001) and old age Group III (P<0.05). Obese Group II showed elevated serum levels of AT1 and AT2 than the Lean Group I and old aged Group III (P<0.001 and P<0.01 respectively in both parameters). Obese Group II also showed significant elevation of serum levels of FGF23, PTH and S.PO4 when compared to the lean Group I values (P values were <0.001, <0.01 and <0.05 respectively). Angiotensin receptors level (AT1 & AT2) both showed significant rise in the obese group than the lean and the old aged groups of patients (P<0.001 and P<0.01 respectively). Conclusion These results support the proposal that obesity per se is an independent risk factor in the development of chronic kidney disease, particularly, in young age patients.
