Abstract: SA-PO1096
Impact of Hyperglycemia on Renal Prognosis in Lean Individuals
Session Information
- CKD Epidemiology, Risk Factors, Prevention - III
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Author
- Araki, Makoto, Sapporo Tokushukai Hospital, Sapporo, Japan
Background
Obesity not only affects blood glucose but also influences haemodynamics and adipocytokines, making it unclear to what extent hyperglycemia alone contributes to organ damage. Therefore, our aim was to investigate the specific impact of hyperglycemia on renal prognosis in lean individuals with elevated blood glucose levels.
Methods
In this single-center study from 2012 to 2022, we analyzed body mass index (BMI), estimated glomerular filtration rate (eGFR), and hemoglobin A1c (HbA1C) data. Individuals with a BMI <18.5 at any time were selected, excluding those under 18 years old, on dialysis, or with one year of data. Participants with HbA1C >6.5% were assigned to the hyperglycemic group (HBG), while the rest formed the control group (CG). Propensity score matching adjusted for background factors, and both groups underwent time-to-event analysis for a 40% eGFR decline. A 12-month landmark analysis minimized guarantee time bias.
Results
Among individuals with recorded BMI, 14.2% experienced a BMI below 18.5 during the study. Out of the initial 3149 individuals, 516 were classified as HBG, having a significantly higher average age than CG (74.3 vs. 63.7 years). Among those who did not reach a renal function endpoint within one year of enrollment, we selected a final sample of 484 patients in each group after adjusting for background factors including gender, age, first-year eGFR, duration of observation, and minimum BMI. The selected participants had a mean age of 74.9 years, mean duration of observation of 1755.4 days, and mean minimum BMI of 16.5. Survival time analysis showed that HBG reached the endpoint significantly more often than CG (Hazard ratio: 1.56 (95%CI 1.20-2.03), P < 0.001).
Conclusion
Lean individuals with hyperglycemia, who were more likely to be elderly, exhibited a significantly higher prevalence of impaired renal function compared to background-matched controls.