People with chronic kidney disease (CKD) with large fluctuations in their body weight or fasting glucose levels tended to have worse health outcomes, including a higher risk of death, according to the results of a new study published in the Journal of the American Society of Nephrology.
CKD develops when the kidneys can no longer effectively remove waste products from the blood. As kidney function declines, many people with CKD end up needing dialysis, or mechanical removal of waste products form their blood. While many factors can affect the risk of developing CKD, diabetes is a leading cause of the disease, as high blood glucose levels can damage the tiny blood vessels in the kidneys over time.
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The latest study looked at 84,636 people with CKD who weren’t dependent on dialysis at the beginning of the study. Based on records of their body weight over a median period of about four years, the researchers divided participants into four groups according to body weight changes — looking just at how much their body weight changed, regardless of their average body weight during the study period. They then looked at how a variety of health outcomes varied between the four groups.
As noted in an article on the study at MedPage Today, members of the group with the greatest changes in body weight were 66% more likely to die from any cause during the study period, compared with the group that experienced the least variation in body weight. They were also 19% more likely to have a heart attack, as well as 19% more likely to have a stroke. When it came to kidney function, the group with the greatest weight variation was 20% more likely to need dialysis at some point during the study period.
This study wasn’t designed to look only at body weight fluctuation — instead, it looked at a number of different factors that might be related to health outcomes in people with CKD. While body weight fluctuation was strongly linked to the overall risk of death, an even greater link was found between changes in fasting glucose levels and the risk of dying. When participants were divided into four groups based on changes in their recorded fasting glucose levels, members of the group with the highest glucose variability were 69% more likely to die during the study period, compared with those who saw the greatest stability in fasting glucose levels over time. They were also 69% more likely to have a heart attack during the study period.
The researchers concluded that stability in certain measurements, including body weight and fasting glucose levels, may be crucial for health and longevity in people with CKD. It’s unclear exactly why greater changes in these measurements may lead to worse health outcomes, but it may be related to these changes putting a greater burden on the kidneys. It’s important to note, though, that this study was observational, so it can’t definitely show that any factor directly caused an outcome — it’s possible, for example, that people with the greatest fasting glucose variability also had other traits that led to greater kidney damage. Still, the results show that at least in people with CKD, it may be important to maintain stability in your body weight and glucose control to help preserve kidney health and overall health and longevity.
Want to learn more about keeping your kidneys healthy with diabetes? Read “Managing Diabetic Kidney Disease,” “Protecting Your Kidneys,” and “Kidney Disease: Your Seven-Step Plan for Prevention.”