Kidney Week

Abstract: TH-PO455

Overweight and Obesity Are Associated with Lower Kidney Blood Flow in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Session Information

• Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Birznieks, Carissa L., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Carissa L. Birznieks, MS

• Wang, Wei, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Wei Wang, MD

• Steele, Cortney, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Cortney Steele, PhD

• Gitomer, Berenice Y., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Berenice Y. Gitomer, PhD

• Chonchol, Michel, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Michel Chonchol, MD, FASN

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Kristen L. Nowak, PhD, MPH

Background

We have previously reported that overweight and obesity are independently associated with more rapid progression in adults with early-stage ADPKD. Renal blood flow (RBF) precedes the decline in eGFR and is associated with faster kidney growth. We now evaluated whether overweight and obesity are also associated with changes in renal blood flow.

Methods

150 non-diabetic adults (25-60 years of age) with ADPKD and an eGFR ≥60 ml/min/1.73m² who participated in a randomized controlled trial of pravastatin therapy were categorized based on baseline body mass index (BMI) as normal weight (n=68 [45%], overweight (n=53 [35%], or obese (n=26 [17%]. RBF was measured by phase contrast MRI, analyzed using Segment for Research (Medviso), and adjusted for body surface area (BSA) prior to analysis. The association of baseline BMI with baseline RBF was assessed using multivariable linear regression.

Results

Participants were 40±10 years (mean+s.d), 65% female, with a baseline RBF of 635±214 ml/min/1.73m², and a baseline eGFR of 90±21 ml/min/1.73m². BSA-adjusted RBF was lower in a stepwise manner with increasing BMI category (Figure). After adjustment for demographics, systolic blood pressure, blood glucose, HDL, eGFR, and height-adjusted total kidney volume, both overweight (β-estimate: -116.8; 95% CI: -168.8 -64.8) and obesity (β-estimate: -289.2; 95% CI: -361.5, -216.9) remained significantly associated with lower RBF as compared to normal weight participants. For every one unit increase in BMI, RBF was 20.6 ml/min/1.73m² lower (95% CI: -25.2, -16.1) in the fully adjusted model.

Conclusion

Overweight and obesity are associated with lower RBF in patients with early-stage ADPKD. Prior research in adults without ADPKD have been discordant, reporting both higher and lower RBF with overweight or obesity. Further research is needed to evaluate whether reduced RBF may be a mechanism by which obesity is associated with faster progression in patients with ADPKD.

Funding

• NIDDK Support