SynthesisBMJ (Clinical research ed.)2019
Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium.
Synthesis in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 133 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
133 citing papers in PubMed, 11 syntheses or guidelines pooled it, 223 citations in OpenAlex.
- Clinical guidelines on physical activity and exercise therapy for Chinese adults with type 2 diabetes: A clinical practice guideline from the Chinese Society of Endocrinology.Journal of sport and health science · 2026Guideline
- National Heart Center/Saudi Heart Association 2025 Guidelines for Cardiovascular Diseases Prevention and Risk Assessment.Saudi medical journal · 2026Guideline
- Saudi Clinical Practice Guidelines for management of diabetic kidney disease in adults.Saudi medical journal · 2025Guideline
- Effects of additional physical exercise on the nutritional status and disease progression during the low-protein diet in Chronic Kidney Disease Patients: a systematic review and meta-analysis.European journal of clinical nutrition · 2024Pooled it
- Beneficial effects of physical exercise on the osteo-renal Klotho-FGF-23 axis in Chronic Kidney Disease: A systematic review with meta-analysis.International journal of medical sciences · 2024Pooled it
- Efficacy and late kidney effects of nephron-sparing surgery in the management of unilateral Wilms tumor: a systematic review and meta-analysis.Pediatric surgery international · 2023Pooled it
- Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis.International journal of obesity (2005) · 2023Pooled it
- Comparison of Kidney Transplantation Outcomes Between Patients with and Without Pre-transplantation Bariatric Surgery: a Systematic Review.Obesity surgery · 2022Pooled it
- Obesity and Kidney Function: A Two-Sample Mendelian Randomization Study.Clinical chemistry · 2022Pooled it
- The association between hypertriglyceridemic-waist phenotype and chronic kidney disease: a cohort study and meta-analysis.Scientific reports · 2022Pooled it
- Efficacy of aerobic exercise on the cardiometabolic and renal outcomes in patients with chronic kidney disease: a systematic review of randomized controlled trials.Journal of nephrology · 2021Pooled it
- Trial
- Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial.Nutrition & diabetes · 2024Trial
- Modification of the effects of intensive systolic blood pressure control on kidney outcomes by baseline body mass index.Nephrology (Carlton, Vic.) · 2021Trial
- Exenatide once weekly decreases urinary albumin excretion in patients with type 2 diabetes and elevated albuminuria: Pooled analysis of randomized active controlled clinical trials.Diabetes, obesity & metabolism · 2020Trial
- The "obesity paradox" in dosing: a comprehensive analytical review of cockcroft-gault versus CKD-EPI for predicting clearance of narrow-therapeutic-index drugs in patients with BMI > 40 kg/m².European journal of clinical pharmacology · 2026Review
- Night shift work and the acceleration of chronic kidney disease onset: dose-response relationships, interactions with cardiometabolic genetic risk, and metabolomic mediators.Scandinavian journal of work, environment & health · 2026Article
- Combined impact of microalbuminuria and obesity on cardiovascular outcomes in hospitalized heart failure patients: a cohort study.BMC cardiovascular disorders · 2026Observational
- Baseline and Follow-Up Association between Adiposity and Renal Function: Data from the ILERVAS Cohort.Obesity facts · 2026Article
- Non-linear relationship between BMI and eGFR at admission in elderly patients with hip fractures: a retrospective cross-sectional study.BMC geriatrics · 2026Article
73 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors at 20 institutions in 13 countries.
Funding
Abstract
objectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.
designIndividual participant data meta-analysis.
settingCohorts from 40 countries with data collected between 1970 and 2017.
participantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).
main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR <10 mL/min/1.73 m
resultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.
conclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.