Body mass index and metabolic factors predict glomerular filtration rate and albuminuria over 20 years in a high-risk population

BACKGROUND The number of individuals suffering from chronic kidney disease (CKD) is increasing. Therefore, early identification of modifiable predictors of CKD is highly desirable. Previous studies suggest an association between body mass index (BMI), metabolic factors and CKD. METHODS Data of 241 high risk patients with information on renal function and albuminuria from the Renal Disease in Vorarlberg (RENVOR) study (2010-2011) were linked with long-term measurements of metabolic factors in the same patients from the population-based Vorarlberg Health Monitoring & Prevention Program (VHM&PP) cohort study (1988-2005). Actual estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (ACR) were determined. BMI, blood pressure, fasting glucose, total cholesterol, triglycerides and Gamma-glutamyltransferase (GGT) were available from previous health examinations performed up to 25 years ago. Linear regression models were applied to identify predictors of current renal function. RESULTS At all-time points BMI was significantly inversely associated with actual eGFR and positively with actual albuminuria in men, but not in women. Serum GGT and triglycerides were significantly positively associated with albuminuria in men at all-time points. Fasting glucose levels more than 20 years earlier were associated with increased albuminuria in women and reduced eGFR in men, whereas at later time points it was associated with albuminuria in men. CONCLUSIONS BMI, serum GGT, and triglycerides are long-term predictors of renal function in men. In women however, anthropometric and metabolic parameters seem to be less predictive of eGFR and albuminuria.