Obesity and chronic kidney disease (CKD) are major public health problems. Obesity independent of its relationship with diabetes and hypertension is associated with the development and progression of kidney disease. However, higher body mass index (BMI) in those with pre-existing CKD is associated with lower mortality (obesity paradox). Ths may be due to the inability of BMI to differentiate fat mass and muscle mass, which may have opposite relationship with cardiovascular disease and death. Body fat distribution is a major facto that determines the metabolic health with visceral adiposity correlating better with metabolic abnormaliies than the subcutaneous adipose tissue. Further, higher fitness level among those with higher BMI is associated with lower prevalence of cardiovascular risk factors and mortality that might explain ths obesity paradox. Therefore, in this study, we propose to examine whether visceral adiposity (as measured by magnetic resonance imaging of abdomen) and physical fitness (as measured by 400 m walk test) are associated with higher incidence of composite outcomes (a composite of mortality, cardiovascular events, end stage renal disease and 50 percent decline in estimated glomerular filtration rate) among participants who are recruited to the phase Ill of the Chronic Renal Insuffiiency Cohort (CRIC) study. In addition, we will also study whether visceral adiposity and physical fitnes are associated with altered adipokine profile, inflammation, insulin resistance, and oxidative stress aong CRIC participants. These would also help us understand the influence of physical fitness on cardiovascular disease and kidney disease progression among kidney disease patients with varying degrees of visceral adiposity. This study results would also provide Insights into the mechanisms tat underpin these relationships thereby providing an opportunity to develop interventions targeting thse cardiovascular and renal risk factors that are relevant in this population.

Public Health Relevance

Chronic kidney disease and obesity are major public health problems. This study will help us understand the effects of visceral adiposity and physical fitness on cardiovascular disease, renal disease progression and death among those with chronic kidney disease. Further, it will identify mechanisms that could be targeted to reduce the detrimental effects of visceral adiposity in those with kidney disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
7R01DK101500-03
Application #
9206248
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Kusek, John W
Project Start
2014-09-22
Project End
2019-07-31
Budget Start
2015-08-03
Budget End
2016-07-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Baylor College of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
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Navaneethan, Sankar D; Schold, Jesse D; Walther, Carl P et al. (2018) High-density lipoprotein cholesterol and causes of death in chronic kidney disease. J Clin Lipidol 12:1061-1071.e7
Grams, Morgan E; Shafi, Tariq; Rhee, Eugene P (2018) Metabolomics Research in Chronic Kidney Disease. J Am Soc Nephrol 29:1588-1590
Walther, Carl P; Chandra, Aravind; Navaneethan, Sankar D (2018) Blood pressure parameters and morbid and mortal outcomes in nondialysis-dependent chronic kidney disease. Curr Opin Nephrol Hypertens 27:16-22
Huang, Haiquan; Jolly, Stacey E; Airy, Medha et al. (2017) Associations of dysnatremias with mortality in chronic kidney disease. Nephrol Dial Transplant 32:1204-1210
Navaneethan, Sankar D; Schold, Jesse D; Jolly, Stacey E et al. (2017) Blood pressure parameters are associated with all-cause and cause-specific mortality in chronic kidney disease. Kidney Int 92:1272-1281
Walther, Carl P; Navaneethan, Sankar D (2017) Inflammation as a Therapeutic Target To Improve Vascular Function in Kidney Disease. J Am Soc Nephrol 28:723-725
Navaneethan, Sankar D; Schold, Jesse D; Jolly, Stacey E et al. (2017) Diabetes Control and the Risks of ESRD and Mortality in Patients With CKD. Am J Kidney Dis 70:191-198
Agrawal, Varun; Navaneethan, Sankar D (2016) Bariatric surgery for obesity-associated decline in kidney function: filling the knowledge gap? Kidney Int 90:28-30
Yan, Jingyin; Navaneethan, Sankar D (2016) Copeptin and Decline in Kidney Function. Am J Nephrol 44:19-21

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