Obesity – the risk factor of cardiovascular disease in patients with chronic kidney disease?

Česká verzia

Authors: D. Ližičárová; E. Hirnerová; B. Krahulec
Authors place of work: II. interná klinika Lekárskej fakulty UK a FN Staré Mesto Bratislava, Slovenská republika, prednosta prof. MU Dr. Andrej Dukát, CSc., FESC
Published in the journal: Vnitř Lék 2010; 56(10): 1088-1092
Category: Obesity 2010

Summary

In general population obesity is regarded as a predisposing factor for chronic disease such as type 2 diabetes and cardiovascular disease. Obesity increases the risk of kidney disease and adversely affects the progress of kidney disease among patients with diagnosed kidney disease. The main reason of mortality in chronic kidney disease patients is cardiovascular disease, however, the real meaning of obesity as a risk factor of cardiovascular diseases is still uncertain. While in a general population obesity causes higher cardiovascular mortality, many studies reflect inverse association in chronic kidney disease patients. Obesity is associated with better survival, contrary to general population obesity appears to be a protective factor of cardiovascular disease. The name of this phenomenon is “reverse epidemiology” or “obesity paradox”, in dialysis patients known as a “risk‑factor‑ paradox”. Some studies do not confirm this paradox association in patients with chronic kidney disease.

Key words:
obesity – reverse epidemiology – chronic kidney disease – cardiovascular disease

Zdroje

1. Lavie CJ, Milani R, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009; 53: 1925– 1932.

2. Weber MA, Neutel JM, Smith DH. Contrasting clinical properties and exercise responses in obese and lean hypertensive patients. J Am Coll Cardiol 2001; 37: 169– 174.

3. Degoulet P, Legrain M, Réach I et al. Mortality risk factors in patients treated by chronic hemodialysis. Report of the Diaphane collaborative study. Nephron 1982; 31: 103– 110.

4. Kalantar‑ Zadeh K, Kopple JD. Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. Am J Kidney Dis 2001; 38: 1343– 1350.

5. Horwich TB, Fonarow GC, Hamilton MA et al. The relationship between obesity and mortality in patients with heart failure. J Am Coll Cardiol 2001; 38: 789– 795.

6. Marti S, Muñoz X, Rios J et al. Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy. Eur Respir J 2006; 27: 689– 696.

7. Escalante A, Haas RW, del Rincón I. Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med 2005; 165: 1624– 1629.

8. Navarro WH, Loberiza FR Jr, Bajorunaite R et al. Effect of body mass index on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation. Biol Blood Marrow Transplant 2006; 12: 541– 551.

9. Kalantar‑ Zadeh K, Block G, Humphreys MH et al. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003; 63: 793– 808.

10. Wang Y, Chen X, Song Y et al. Association between obesity and kidney disease: a systematic review and meta‑analysis. Kidney Int 2008; 73: 19– 33.

11. Hsu CY, McCulloch CE, Iribarren C et al. Body mass index and risk for end‑stage renal disease. Ann Intern Med 2006; 144: 21– 28.

12. Fox CS, Larson MG, Leip EP et al. Predictors of new‑onset kidney disease in a community‑based population. JAMA 2004; 291: 844– 850.

13. Goumenos DS, Kawar B, El Nahas M et al. Early histological changes in the kidney of people with morbid obesity. Nephrol Dial Transplant 2009; 24: 3732– 3738.

14. Manson JE, Willett WC, Stampfer MJ et al. Body weight and mortality among women. N Engl J Med 1995; 333: 677– 685.

15. Yusuf S, Hawken S, Ounpuu S et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case‑ control study. Lancet 2005; 366: 1640– 1649.

16. Kenchaiah S, Evans JC, Levy D et al. Obesity and the risk of heart failure. N Engl J Med 2002; 347: 305– 313.

17. Zager PG, Nikolic J, Brown RH et al. “U” curve association of blood pressure and mortality in hemodialysis patients. Medical Directors od Dialysis Clinic, Inc. Kidney Int 1998; 54: 561– 569.

18. Nishizawa Y, Shoji T, Ishimura E et al. Paradox of risk factors for cardiovascular mortality in uremia: is a higher cholesterol level better for atherosclerosis in uremia? Am J Kidney Dis 2001; 38 (4 Suppl 1): S4– S7.

19. Kalantar‑ Zadeh K, Block G, Humphreys MH et al. A low, rather than a high, total plasma homocysteine is an indicator of poor outcome in hemodialysis patients. J Am Soc Nephrol 2004; 15: 442– 453.

20. Lowrie EG, Lew NL. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 1990; 15: 458– 482.

21. Fleischmann EH, Bower JD, Salahudeen AK. Risk factor paradox in hemodialysis: better nutrition as a partial explanation. Asaio J 2001; 47: 74– 81.

22. Johansen KL, Young B, Kaysen GA et al. Association of body size with outcomes among patients beginning dialysis. Am J Clin Nutr 2004; 80: 324– 332.

23. Abbott KC, Glanton CW, Trespalacios FC et al. Body mass index, dialysis modality, and survival: analysis of the United States Renal Data System Dialysis Morbidity and Mortality Wave II Study. Kidney Int 2004; 65: 597– 605.

24. Foley RN, Parfrey PS, Sarnak MJ. Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 1998; 9 (Suppl 12): S16– S23.

25. Fleischmann E, Teal N, Dudley J et al. Influence of excess weight on mortality and hospital stay in 1346 hemodialysis patients. Kidney Int 1999; 55: 1560– 1567.

26. Leavey SF, McCullough K, Hecking E et al. Body mass index and mortality in „healthier“ as compared with „sicker“ haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOOPS). Nephrol Dial Transplant 2001; 16: 2386– 2394.

27. Kopple JD, Zhu X, Lew NL et al. Body weight‑ for‑ height relationships predict mortality in maintenance hemodialysis patients. Kidney Int 1999; 56: 1136– 1148.

28. Port FK, Ashby VB, Dhingra RK et al: Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. J Am Soc Nephrol 2002; 13: 1061– 1066.

29. Aoyagi T, Naka H, Miyaji K et al. Body mass index for chronic hemodialysis patients: stable hemodialysis and mortality. Int J Urol 2001; 8: S71– S75.

30. Kutner NG, Zhang R. Body mass index as a predictor of continued survival in older chronic dialysis patients. Int Urol Nephrol 2001; 32: 441– 448.

31. Johnson DW, Herzig KA, Purdie DM et al. Is obesity a favorable prognostic factor in peritoneal dialysis patients? Perit Dial Int 2000; 20: 715– 721.

32. Wong JS, Port FK, Hulbert‑ Shearon TE et al. Survival advantage in Asian American end‑stage renal disease patients. Kidney Int 1999; 55: 2515– 2523.

33. Beddhu S, Pappas LM, Ramkumar N et al. Effects of body size and body composition on survival in hemodialysis patients. J Am Soc Nephrol 2003; 14: 2366– 2372.

34. Martín‑ Ponce E, Santolaria F, Alemán‑ Valls MR et al. Factors involved in the paradox of reverse epidemiology. Clin Nutr 2010; 29: 501– 506.

35. Lavie CJ, Milani RV, Ventura HO. Obesity, heart disease, and favorable prognosis: truth or paradox? Am J Med 2007; 120: 825– 826.

36. Fonarow GC, Chelimsky‑ Fallick C, Stevenson LW et al. Effect of direct vasodilatation with hydralazine versus angiotensin‑converting enzyme inhibition with captopril on mortality in advanced heart failure: the Hy‑ C trial. J Am Coll Cardiol 1992; 19: 842– 850.

37. Feldman AM, Combes A, Wagner D et al. The role of tumor necrosis factor in the pathophysiology of heart failure. J Am Coll Cardiol 2000; 35: 537– 544.

38. Kalantar‑ Zadeh K, Kopple JD, Humphreys MH et al. Comparing outcome predictability of markers of malnutrition‑ inflammation complex syndrome in haemodialysis patients. Nephrol Dial Transplant 2004; 19: 1507– 1519.

39. Mohamed‑ Ali V, Goodrick S, Bulmer K et al. Production of soluble tumor necrosis factor receptors by human subcutaneous adipose tissue in vivo. Am J Physiol 1999; 277: E971– E975.

40. Kalantar‑ Zadeh K, Kamranpour N, Kopple JD. Association between novel HDL inflammatory/ anti‑inflammatory properties with body mass index in hemodialysis patients. J Am Soc Nephrol 2004; 15 (Suppl): 172A.

41. Schrier RW, Abraham WT. Hormones and hemodynamics in heart failure. N Engl J Med 1999; 341: 577– 585.

42. Salahudeen AK, Fleischmann EH, Bower JD et al. Underweight rather than overweight is associated with higher prevalence of hypertension: BP vs BMI in haemodialysis population. Nephrol Dial Transplant 2004; 19: 427– 432.

43. Rauchhaus M, Coats AJ, Anker SD. The endotoxin‑lipoprotein hypothesis. Lancet 2000; 356: 930– 933.

44. Niebauer J, Volk HD, Kemp M et al. Endotoxin and immune activation in chronic heart failure: a prospective cohort study. Lancet 1999; 353: 1838– 1842.

45. Kalantar‑ Zadeh K, Anker SD. Inflammation, cholesterol levels, and risk of mortality among patients receiving dialysis. JAMA 2004; 291: 1833– 1834.

46. Kalantar‑ Zadeh K, Ikizler TA, Block G et al. Malnutrition‑ inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis 2003; 42: 864– 881.

47. Kalantar‑ Zadeh K, Kopple J. Inflammation in renal failure. In: Rose B (ed). Wellesley MA: UpToDate, Inc. 2004.

48. Kalantar‑ Zadeh K, Block G, McAllister CJ et al. Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. Am J Clin Nutr 2004; 80: 299– 307.

49. Bergström J, Lindholm B. Malnutrition, cardiac disease, and mortality: an integrated point of view. Am J Kidney Dis 1998; 32: 834– 841.

50. Ritz E. Why are lipids not predictive of cardiovascular death in the dialysis patient? Miner Electrolyte Metab 1996; 22: 9– 12.

51. Kalantar‑ Zadeh K, Kopple JD. Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. Am J Kidney Dis 2001; 38: 1343– 1350.

52. Lowrie E. Acute‑ phase inflammatory process contributes to malnutrition, anemia, and possibly other abnormalities in dialysis patients. Am J Kidney Dis 1998; 32 (6 Suppl 4): S105– S112.

53. Zeman D. Obezita a metabolický syndróm. Vnitř Lék 2005; 51: 72– 75.