ArticleJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation2019
Chronic Kidney Disease and the Adiposity Paradox: Valid or Confounded?
Article in Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Mechanisms of Obesity-Related Kidney Disease: From Adipose Depot Biology to the Chymase-Aldosterone and Ghrelin-Leptin Axes.Biomolecules · 2026Review
- Association of Body Roundness Index with all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3: a cohort study.American heart journal plus : cardiology research and practice · 2026Article
- Inflammatory biomarkers are associated with renal injury and partially explain the obesity-renal injury relationship in U.S. adolescents: a cross-sectional NHANES study.BMC nephrology · 2026Article
- Development of a risk prediction model for dialysis access steal syndrome: exploring the interaction and modifying role of BMI.Frontiers in public health · 2026Article
- Body Mass Index and Clinical and Health Status Outcomes in Chronic Coronary Disease and Advanced Kidney Disease in the ISCHEMIA-CKD Trial.The American journal of medicine · 2024Article
- Editorial: Obesity and chronic kidney disease: complexities, clinical impact, and challenges in nutritional management.Frontiers in nutrition · 2023Article
- Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3-5 chronic kidney disease.Frontiers in nutrition · 2022Article
- Hand Grip and Leg Muscle Strength in Hemodialysis Patients and Its Determinants.Journal of Korean medical science · 2021Article
- Epidemiology and outcomes of obese critically ill patients in Australia and New Zealand.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2020Observational
- Under-Recognizing Malnutrition in Hospitalized Obese Populations: The Real Paradox.Current nutrition reports · 2019Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveObesity, defined by body mass index (BMI), is associated with lower mortality risk in patients with chronic kidney disease (CKD). BMI and % body fat (%BF) are confounded by muscle mass, while DXA derived fat mass index (FMI) overcomes this limitation. We compared the associations between obesity and mortality in persons with CKD using multiple estimates of adiposity, and determined whether muscle mass, inflammation and weight loss modify these associations.
methodsObesity was defined using BMI and DXA-derived FMI and %BF cut-offs in 2,852 NHANES participants with CKD from 1999-2006 and linked to the National Death Index with follow up through 2011. Cox proportional hazards models assessed associations between mortality and measures of obesity.
resultsObesity based on FMI and continuous variables, FMI, BMI and %BF were associated with lower mortality. The protective association of obesity was less pronounced among participants with higher muscle mass and was no longer significant after adjustment for prior weight loss. Inflammation did not modify these associations.
conclusionsWe observed lower mortality associated with higher fat mass, particularly among persons with lower muscle mass. The prevalence of >10% weight loss was half as common among obese compared to non-obese participants and confounded these associations.
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Registered trials
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