The association between waist circumference and renal insufficiency among hypertensive patients
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The Association between Waist Circumference and Renal Insufficiency among Hypertensive Patients. Mrs. Watcharasa Pitug ID. 567110011-2. Contents. Background/Rationale Objective Methods Results Discussion &Conclusions. Background/Rationale.

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The Association between Waist Circumference and Renal Insufficiency among Hypertensive Patients

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The association between waist circumference and renal insufficiency among hypertensive patients

The Association between Waist Circumference and Renal Insufficiency among Hypertensive Patients

Mrs. Watcharasa Pitug

ID. 567110011-2


Contents

Contents

  • Background/Rationale

  • Objective

  • Methods

  • Results

  • Discussion &Conclusions


Background rationale

Background/Rationale

Chronic kidney disease (CKD) has become a global public health problem and is a common condition in the United States

(Alejandro et al.,2009 ; Essam et al.,2008 ; Adam et al., 2007)

In 2004, there were approximately 472,000 patients with treated ESRD (Alejandro et al.,2009 )

By 2030, expected to increase to more than 2 million. The estimated prevalence of earlier CKD stages (stages 1 through 4) in US adults was 24 to 28 million based on the 2000

(Adam et al., 2007)


Chronic kidney disease classification and clinical consequences

Chronic kidney disease: classification and clinical consequences

Relative risk of death in relation to kidney function

(N=1,120,295 pts)

CKD -KDOQI classification

Go AS et., 2004


Modification of diet in renal disease mdrd in thailand

Modification of Diet in Renal Disease (MDRD) in Thailand

In 2007 : Chronic Renal Insufficiency patients 13.2% in state 3 and 0.61% in state 4

(ThaweeSiriwong, 2007)

In 2008 : Chronic Renal Insufficiency patients in Thailand 17.5% (สมาคมโรคไตแห่งประเทศไทย, 2008)


Clinical complications of renal failure

Clinical complications of renal failure

Loss of erythropoietin –anaemia

Parathyroid gland disturbances –renal bone disease

Myocardial fibrosis and cardiomyopathy

Active vitamin D

deficiency

Immunodeficiency

Atherosclerosis

and

arteriosclerosis

Malnutrition/wasting

..and many others

Polyneuropathy

No diuresis –overhydration


Gab of knowledge

Gab of knowledge

  • The relationship of obesity to Renal insufficiency is somewhat controversial. While it is established that obesity increases the risk of hypertension, diabetes and dyslipidemia

  • it is not clear if excess waist circumference influences Renal insufficiency independently

Correlation between waist circumference and (A) visceral and (B) subcutaneous fat areas assessed by using computed tomography in 75 men (open circle; dotted lines) and 47 women (filled triangle; solid lines) with prevalent chronic kidney disease.

Fabiana et al.,2008


The association between waist circumference and renal insufficiency among hypertensive patients

Objective

  • To investigate the association between waist circumference and Renal insufficiency among hypertensive patients

Methods

  • Analytic study was conducted all information were collected from medical records of all patients diagnosed with Hypertension during 2012. The type of hypertension complications was based on Renal insufficiency was the main outcome of this study.


The inclusion flow chart

Methods

The inclusion flow chart

Sampling frame

DM, HT & DMHT

N=61,706

Exclude DM & DMHT

(n=28,938)

Sample

only HT patients

(n=32,768)

Exclude if not estimate waist circumference

(n=23,287)

Study participants

(n=9,481)


Modification of diet in renal disease mdrd in thailand1

Methods

Modification of Diet in Renal Disease (MDRD) in Thailand

Go AS et., 2004


Variables and measurements

Methods

Variables and measurements


Variables and measurements1

Methods

Variables and measurements


Statistic analysis

Methods

Statistic Analysis

  • Demographic characteristics were described using frequency and percentage for categorical data such as gender, age group,WC group, BMI group, Cigarette smoking use, fasting plasma glucose group, total cholesterol group, triglyceride group, HDL cholesterol group, LDL cholesterol group, hemoglobin group and hematocrit group.

  • Using mean, standard deviation, median, minimum, and maximum to described continuous data such as age, BMI, fasting plasma glucose level, total cholesterol level, triglyceride level, HDL cholesterol level, LDL cholesterol level, hemoglobin level and hematocrit level.

  • To investigate factors that associated with chronic renal insufficiency, adjusted odds ratios (ORs) and their 95% confidence intervals (95%CIs) were estimated using multiple logistic regression.

  • All test statistics were p-value of less than 0.05 was considered statistical significant.

  • All analyses were performed by using STATA version 12.0 (AtataCorp, College Station, TX).


Results

Results

Basic characteristic of the individual included in the study


Results1

Results

Basic characteristic of the individual included in the study


The association between waist circumference and renal insufficiency among hypertensive patients

Results

Basic characteristic of the individual included in the study


Crude odds ratios of having renal insufficiency and their 95 confidence intervals for each factor

Crude odds ratios of having Renal Insufficiency and their 95% confidence intervals for each factor


The association between waist circumference and renal insufficiency among hypertensive patients

Odds ratios (ORs) of having Renal Insufficiency and their 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)


The association between waist circumference and renal insufficiency among hypertensive patients

Odds ratios (ORs) of having Renal Insufficiency and their 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)


The association between waist circumference and renal insufficiency among hypertensive patients

Forest plotwas compare for each factors affecting chronic renal insufficiency, presented as odds ratio adjusted for waist circumference, age, gender, BMI, smoking, triglyceride, and Hemoglobin, using multiple logistic regression


Discussion conclusions

Discussion & Conclusions

1

2

1

2


Discussion conclusions1

Discussion & Conclusions


Discussion conclusions2

Discussion & Conclusions


Discussion conclusions3

Discussion & Conclusions

In summary, in agreement with the findings in the general population, the present study shows that WC is not associated with Chronic Renal Insufficiency in individuals. In previous study, associations found between WC and some CVD risk factors were similar to those observed for visceral fat, suggesting that WC is a simple and economic tool to be used more often in epidemiological research also involving patients with CKD. Prospective studies are necessary to evaluate the reproducibility of WC and the ability of this method to predict outcomes in patients with CKD.


The association between waist circumference and renal insufficiency among hypertensive patients

Thanks for your attention


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