The Surprising Risks of Obesity in CKD

Obesity may increase survival in dialysis, but fat cells can still have many negative effects, ex

Even though obesity is paradoxically associated with better survival in some chronic kidney disease patients, being overweight can be just as dangerous for kidney patients as it is for the general population, according to a presentation at the National Kidney Foundation’s 2008 Spring Clinical Meetings held here. 

Research has consistently shown that high body mass index, while a major cause of morbidity among the general population, is linked to better survival in dialysis patients. This trend has caused some experts to suspect that obesity may somehow be beneficial in CKD.

Srinivasan Beddhu, Associate Professor of Medicine at the University of Utah, however, argues that this is not the case.

“The same metabolic abnormalities associated with obesity that you see in the general population are also seen in the CKD and dialysis population,” says Beddhu, who will present emerging data about the risks of obesity in dialysis during the SCM.

These metabolic abnormalities present in obese CKD patients include insulin resistance, atherosclerosis, and inflammation.

As a result, nephrologists and other doctors who treat CKD patients need to take fat mass seriously, and investigators should focus on ways to minimize the negative effects of obesity without diminishing its benefit on survival, Beddhu recommends.

The effects of obesity in CKD are likely quite complex, says Beddhu. Obesity isn’t “good” or “bad” in CKD – it is probably both.

Specifically, dialysis patients with excess BMI may eat more and therefore have more nutrients, which helps their survival. But emerging data is showing that obesity still has negative metabolic effects in CKD – increasing the risk of insulin resistance, inflammation, dyslipidemia, atherosclerosis, and coronary calcification.

In CKD, the good and bad effects of obesity likely engage in a “tug of war,” Beddhu speculates – and when the good effects take the lead, excess pounds can boost survival. The overall effects of obesity may vary according to kidney function, with the benefits increasing as kidney function goes down.

“It’s not that fat isn’t bad in kidney patients – quite the opposite,” he explains. “It’s just that being overweight is linked to other, healthy benefits, which can sometimes outweigh the negative effects.”

Beddhu will discuss recent data about the risks of obesity in CKD on April 4, 2008, from 1:15 to 3:15 during session #270: Obesity and CKD. Other speakers include Csaba Kovesdy and Allon Friedman.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation.

For more information on kidney disease visit www.kidney.org

Posted under: General Health

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