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Evidence is mixed about whether obesity is associated with excess risk for chronic kidney disease and end-stage renal disease (ESRD). In this meta-analysis on >5 million adults in 40 countries, researchers investigated whether individual measures of adiposity (i.e., body-mass index [BMI], waist circumference, and waist-to-height ratio) were associated with greater risk for glomerular filtration rate (GFR) decline (defined as >40% decline in GFR, GFR of <10 mL/minute/1.73 m2, or initiation of kidney replacement therapy).
During mean follow-up of 8 years, GFR declined substantially in 5.6% of participants, and 0.4% developed ESRD. All-cause mortality was 14% to 19% in the various cohorts. Adjusted for numerous variables (e.g., age, sex, race, …