Among people with type 2 diabetes, higher body weight is linked to a greater risk for diabetic kidney disease, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.
Diabetes is the leading cause of chronic kidney disease (CKD), and both type 1 and type 2 diabetes can lead to kidney damage caused by elevated blood glucose levels over time. Detecting and treating chronic kidney disease early in people with diabetes is important, since kidney damage can progress quickly in people with the condition. In addition to controlling blood glucose levels as effectively as possible, treatment for chronic kidney disease may include taking a drug specifically for the condition, such as Kerendia (finerenone) or Farxiga (dapagliflozin), the latter of which was originally developed as a drug for type 2 diabetes. The goal of treatment for chronic kidney disease is to preserve kidney function for as long as possible, in order to delay or prevent the need for dialysis — artificial filtering of waste products from the blood, once the kidneys are no longer able to accomplish this task effectively.
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For the latest study, researchers were interested in looking at how the risk for chronic kidney disease in people with type 2 diabetes might be affected by body-mass index (BMI, a measure of body weight that takes height into account). To do this, they used data from 3,972 participants with type 2 in a health study in Japan that involved undergoing a genetic analysis. This allowed the researchers to use 56 genetic variants linked to obesity as part of their study design, using a technique called Mendelian randomization. In essence, this means using a trait that people can’t control — like a particular genetic variant that increases the risk for obesity — as a way to look at the effects of being randomly assigned to have obesity. This overcomes the main limitation of looking directly at how obesity is related to kidney disease risk — namely, that many different behaviors could have an impact on both body weight and kidney disease risk.
Higher body weight linked to increased kidney disease risk
The researchers found that for every standard deviation (a statistical measure of how far apart numbers are within a group) increase in BMI, participants were 3.76 times as likely to develop kidney disease. When they looked at men and women separately, they found that the same increase in BMI was linked to 3.48 times the likelihood of developing kidney disease in men, and an astounding 14.81 times the likelihood of developing it in women. BMI wasn’t linked to the risk for high levels of protein in the urine, which is a common sign of poor kidney function.
The researchers concluded that to help people with diabetes prevent chronic kidney disease, it’s important to manage not just blood glucose and blood pressure, but also body weight. And because a greater body weight appears to raise the risk for kidney disease by much more in women than in men with diabetes, women who fall in this category may be candidates for more extensive screening for chronic kidney disease.
Want to learn more about keeping your kidneys healthy with diabetes? Read “Managing Diabetic Kidney Disease,” “How to Keep Your Kidneys Healthy,” “Protecting Your Kidneys,” and “Kidney Disease: Your Seven-Step Plan for Prevention.”